Original title: Managing uterine evacuation in a patient with Asherman syndrome who failed procedural and medication abortions: a case report
Morgan E Johnson, Jaime A Roura-Monllor, Adam D Elwood, Anne Z Steiner +1 · September 2026
Ending an early pregnancy can be very difficult if scar tissue blocks the womb. This case involved a 37-year-old woman with Asherman syndrome, a condition where bands of scar tissue form inside the uterus. Doctors tried vacuum aspiration to gently suction out the pregnancy at 6 weeks 0 days, but scars blocked them from reaching the sac. Next, medications also failed to clear it. A camera-guided surgery called a hysteroscopy could not fully remove it either. Finally, one month later, doctors used another hysteroscopy to successfully clear out the remaining tissue. The report notes that doctors need better guidance for these cases, and suggests careful planning, ultrasound guidance, cameras inside the uterus, and close follow-up visits.
Imagine trying to clean a narrow bottle with a sponge on a stick, but there is a layer of dried glue inside that blocks the sponge from reaching the bottom. No matter how you twist, the sponge cannot get past the glue. Here, the uterus is like the bottle, scar tissue is the glue, and standard abortion methods are like the sponge on a stick. The doctors eventually used a camera-tipped tool that could see and remove the blockage directly.
For patients with Asherman syndrome, standard abortion methods may not work. This case shows that hysteroscopic removal can succeed after other methods fail. It highlights the need for careful planning and follow-up in such rare but challenging situations.
This is a single case report, so the suggested management modalities may not apply to all patients with Asherman syndrome. The patient had a complex history of multiple procedures, which may have influenced outcomes. No control group or standardized protocol was used. Further research is needed to establish evidence-based guidelines.
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Managing uterine evacuation in a patient with Asherman syndrome who failed procedural and medication abortions: a case report — Morgan E Johnson, Jaime A Roura-Monllor, Adam D Elwood et al. — Case reports in women's health — doi:10.1016/j.crwh.2026.e00856
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper.