{"id":17161,"date":"2022-06-21T11:00:33","date_gmt":"2022-06-21T08:00:33","guid":{"rendered":"https:\/\/medimall.gr\/endomitrikes-symfyseis\/"},"modified":"2022-06-24T20:02:50","modified_gmt":"2022-06-24T17:02:50","slug":"adherences-intra-uterines","status":"publish","type":"post","link":"https:\/\/medimall.gr\/fr\/adherences-intra-uterines\/","title":{"rendered":"Adh\u00e9rences intra-ut\u00e9rines"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text]Les adh\u00e9rences endom\u00e9triales sont une cause s\u00e9rieuse d’infertilit\u00e9, tant en tuantit\u00e9 de sang inf\u00e9rieure \u00e0 la normale pendant les r\u00e8gles), des h\u00e9matomermes de difficult\u00e9 de conception que d’ach\u00e8vement de la grossesse, car elles sont responsables de taux de fausses couches pouvant atteindre 80 %. Responsables de l’infertilit\u00e9, des fausses couches \u00e0 r\u00e9p\u00e9tition, de l’am\u00e9norrh\u00e9e secondaire (absence de r\u00e8gles) et de l’oligom\u00e9norrh\u00e9e (qes (remplissage de la cavit\u00e9 endom\u00e9triale par du sang), les adh\u00e9rences endom\u00e9triales sont dues \u00e0 plusieurs facteurs.<\/b><\/p>\n

Que sont les adh\u00e9rences ?<\/span><\/h3>\n

La cavit\u00e9 ut\u00e9rine est tapiss\u00e9e par l’endom\u00e8tre. Cette “doublure” est constitu\u00e9e de deux couches : la couche fonctionnelle, qui est \u00e9limin\u00e9e pendant les menstruations, et une couche basale sous-jacente, qui est n\u00e9cessaire \u00e0 la r\u00e9g\u00e9n\u00e9ration de la couche fonctionnelle. Un traumatisme de la couche basale, g\u00e9n\u00e9ralement apr\u00e8s une dilatation et un curetage, apr\u00e8s une fausse couche ou apr\u00e8s un avortement, peut entra\u00eener le d\u00e9veloppement de cicatrices intra-ut\u00e9rines qui deviennent des adh\u00e9rences et peuvent \u00e9liminer la cavit\u00e9 endom\u00e9triale \u00e0 des degr\u00e9s divers. Les troubles menstruels, l’am\u00e9norrh\u00e9e, l’hypo-m\u00e9norrh\u00e9e et l’oligom\u00e9norrh\u00e9e sont les sympt\u00f4mes connus des adh\u00e9rences au sein de l’ut\u00e9rus. Les anomalies des r\u00e8gles sont souvent, mais pas toujours, corr\u00e9l\u00e9es \u00e0 la gravit\u00e9, par exemple, les adh\u00e9rences dans le col de l’ut\u00e9rus bloquent les menstruations. Les douleurs pendant les menstruations et l’ovulation peuvent \u00e9galement \u00eatre attribu\u00e9es aux adh\u00e9rences. Selon leur gravit\u00e9, elles peuvent entra\u00eener l’infertilit\u00e9, des fausses couches \u00e0 r\u00e9p\u00e9tition, une grossesse extra-ut\u00e9rine, des complications obst\u00e9tricales et des douleurs dues au sang pi\u00e9g\u00e9 dans l’ut\u00e9rus. Et bien s\u00fbr, le sang ut\u00e9rin “pi\u00e9g\u00e9” \u00e0 l’int\u00e9rieur de l’ut\u00e9rus par les adh\u00e9rences peut entra\u00eener une endom\u00e9triose.<\/p>\n

Le syndrome d’Asherman, qui se caract\u00e9rise par une fusion \u00e9tendue des parois de la cavit\u00e9 ut\u00e9rine, entra\u00eene l’absence de cavit\u00e9 ut\u00e9rine et l’absence de r\u00e8gles. Asherman a d\u00e9crit en 1948 comme “am\u00e9norrh\u00e9e traumatique” l’am\u00e9norrh\u00e9e secondaire r\u00e9sultant d’un d\u00e9collement traumatique de l’ut\u00e9rus apr\u00e8s un accouchement, un avortement ou un avortement septique. La restauration de la cavit\u00e9 ut\u00e9rine par lyse des adh\u00e9rences dans le syndrome d’Asherman est extr\u00eamement difficile, voire impossible.<\/p>\n

Traitement<\/span><\/h3>\n

Les adh\u00e9rences sont trait\u00e9es par hyst\u00e9roscopie. Avant l’intervention, une \u00e9valuation pr\u00e9op\u00e9ratoire minutieuse par le chirurgien \u00e0 l’aide d’une \u00e9chographie endovaginale et d’une hyst\u00e9rosalpingographie est n\u00e9cessaire pour d\u00e9terminer l’\u00e9tendue des adh\u00e9rences afin d’\u00e9viter d’\u00e9ventuelles complications (perforation ut\u00e9rine) au moment de l’intervention. Le traitement de l’affection est effectu\u00e9 imm\u00e9diatement et la patiente peut quitter l’h\u00f4pital apr\u00e8s 1 \u00e0 2 heures. Bien entendu, les r\u00e9sultats de la r\u00e9solution des adh\u00e9rences d\u00e9pendent de l’\u00e9tendue, de la localisation, de l’\u00e9paisseur et de la morphologie des adh\u00e9rences (fines et transparentes, ou fermes et fibreuses), les adh\u00e9rences l\u00e9g\u00e8res \u00e0 mod\u00e9r\u00e9es \u00e9tant g\u00e9n\u00e9ralement trait\u00e9es avec succ\u00e8s. Une atteinte \u00e9tendue de la cavit\u00e9 ut\u00e9rine ou des canaux phalangiens et des l\u00e9sions profondes du myom\u00e8tre et de l’endom\u00e8tre peuvent n\u00e9cessiter plusieurs interventions chirurgicales. Dans tous les cas, apr\u00e8s la chirurgie, un cycle d’\u0153strog\u00e9noth\u00e9rapie est administr\u00e9 pour favoriser la repousse de la surface ut\u00e9rine. Apr\u00e8s la chirurgie et l’hormonoth\u00e9rapie, les r\u00e9sultats en termes de retour \u00e0 des menstruations normales et donc de r\u00e9alisation d’une grossesse sont g\u00e9n\u00e9ralement excellents.<\/p>\n

Adh\u00e9rences et grossesse<\/span><\/h3>\n

Pour qu’une femme puisse tomber enceinte apr\u00e8s l’ablation des adh\u00e9rences, il faut proc\u00e9der \u00e0 une FIV, sauf si l’ut\u00e9rus est compl\u00e8tement d\u00e9truit, auquel cas la grossesse ne sera pas possible, m\u00eame avec une FIV. Or, s’il y a une grossesse apr\u00e8s le traitement des adh\u00e9rences endom\u00e9triales, il y a un risque accru de formation anormale du placenta et d’un \u00e9ventuel d\u00e9collement du placenta. Il arrive \u00e9galement que le col de l’ut\u00e9rus ne puisse plus supporter le poids accru du f\u0153tus, la pression peut provoquer la rupture du placenta et un travail pr\u00e9matur\u00e9 peut survenir. Dans ce cas, il est conseill\u00e9 de proc\u00e9der \u00e0 une ligature du col de l’ut\u00e9rus.[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

[vc_row][vc_column][vc_column_text]Les adh\u00e9rences endom\u00e9triales sont une cause s\u00e9rieuse d’infertilit\u00e9, tant en tuantit\u00e9 de sang inf\u00e9rieure \u00e0 la normale pendant les r\u00e8gles), des h\u00e9matomermes de difficult\u00e9 de conception que d’ach\u00e8vement de la grossesse, car elles sont responsables de taux de fausses couches pouvant atteindre 80 %. Responsables de l’infertilit\u00e9, des fausses couches \u00e0 r\u00e9p\u00e9tition, de l’am\u00e9norrh\u00e9e secondaire […]<\/p>\n","protected":false},"author":2,"featured_media":17138,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22],"tags":[],"featured_image_src":{"landsacpe":["https:\/\/medimall.gr\/wp-content\/uploads\/2022\/06\/SDADASDSADA-1140x445.jpg",1140,445,true],"list":["https:\/\/medimall.gr\/wp-content\/uploads\/2022\/06\/SDADASDSADA-463x348.jpg",463,348,true],"medium":["https:\/\/medimall.gr\/wp-content\/uploads\/2022\/06\/SDADASDSADA-300x300.jpg",300,300,true],"full":["https:\/\/medimall.gr\/wp-content\/uploads\/2022\/06\/SDADASDSADA.jpg",1199,1199,false]},"yoast_head":"\nAdh\u00e9rences intra-ut\u00e9rines - Medimall IVF Clinic<\/title>\n<meta name=\"description\" content=\"Adh\u00e9rences intra-ut\u00e9rines - Medimall IVF Clinic\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medimall.gr\/fr\/adherences-intra-uterines\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Adh\u00e9rences intra-ut\u00e9rines - 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