Cervical adhesion

　　Due to excessive vacuum pressure or repeated entry and exit of the vacuum through the cervical os and rough surgical manipulation, as the cervical canal mucosa is thin, it is easy to cause deep injury and form adhesion. Short interval between the last induced abortion and incomplete repair of the cervical canal mucosa can lead to adhesion after repeated injury. Multiple induced abortions can stimulate the cervix repeatedly, causing connective tissue proliferation, hardness, reduced elasticity, and a tight cervical os, thereby further aggravating cervical injury and adhesion. In addition, inadequate sterile concepts of the surgical staff or early sexual activity after abortion, especially in nulliparous or premarital pregnant women, failing to receive contraception measures in a timely manner.

　　Lack of hygiene knowledge increases the opportunity for infection, leading to cervical adhesion. Unfinished induced abortion due to untreated acute or chronic inflammatory diseases of the reproductive tract, especially in patients with various vaginitis and severe cervical erosion, can exacerbate inflammation or further spread, causing cervical adhesion. In summary, there are many causes of cervical adhesion, especially in nulliparous women, women with multiple aspiration procedures, and those with shorter intervals between procedures, the incidence rate is higher.

　　Cervical adhesion can cause lower abdominal pain. If the condition of cervical adhesion continues to worsen, patients may experience abdominal pain, which can greatly affect a woman's life and work. Generally, sudden, spasmodic lower abdominal pain occurs about a month after an induced abortion or curettage. Some patients may experience severe abdominal pain, making it difficult to sit or lie comfortably, and even painful to pass gas or defecate.

　　Cervical adhesion can lead to abnormal menstruation. For those with complete adhesion of the uterine cavity, amenorrhea may occur; for those with partial adhesion of the uterine cavity and/or partial destruction of the endometrium, the manifestation is oligomenorrhea, but the menstrual cycle is normal. If cervical adhesion is caused by cervicitis or other inflammation, amenorrhea may occur, and some patients may have irregular menstruation, prolonged menstrual period, dark menstrual blood, and other abnormal phenomena.

　　Cervical adhesion can lead to abnormal pregnancy, easily causing pregnancy failure, including early and mid-trimester abortion, preterm birth, ectopic pregnancy, missed abortion, etc. Infertility is the most important symptom of cervical adhesion, which often leads to female fallopian tube blockage, causing the fertilized egg to fail to implant normally, leading to infertility in the end.

　　For those with relative adhesion of the uterine cavity, amenorrhea may occur, with a long duration of amenorrhea, and treatment with estrogen and progesterone does not cause withdrawal bleeding. For those with partial adhesion of the uterine cavity and/or partial destruction of the endometrium, the manifestation is oligomenorrhea, but the menstrual cycle is normal. If the adhesion does not seal the entire uterine cavity, the patient may have fertility problems, easily experiencing pregnancy failure, including early and mid-trimester abortion, preterm birth, ectopic pregnancy, missed abortion, intrauterine fetal death, etc. If the pregnancy reaches full term, there may be abnormal placental implantation.

　　Pain usually lasts for 3-7 days and then gradually subsides and disappears, with an interval of about a month, and then a periodic abdominal pain occurs again, which gradually worsens. Generally, about a month after abortion or dilatation and curettage, there is a sudden onset of lower abdominal cramping pain, more than half of which are accompanied by a sensation of anal坠胀; some patients have severe abdominal pain, feel restless and difficult to move, and even suffering from flatulence and defecation, sometimes with a sense of urgency to defecate.

　　Firstly, attention should be paid to the correct method of contraception. If women friends have no choice but to undergo an abortion, they must pay attention to choosing a regular hospital for the operation and let experienced doctors operate to prevent rough operation caused by uterine adhesion.

　　Secondly, attention should be paid to personal hygiene in daily life. Try to use clean water to wash the intimate parts, avoid destroying the acidic environment of the vagina. Regularly clean the washing machine, wear cotton underwear, and pay attention to personal hygiene in public places.

　　Moreover, if women friends have vaginal inflammation and cervical erosion, they must go to a regular hospital for treatment in time to avoid the aggravation or spread of inflammation causing cervical adhesion.

　　Hysteroscopy Examination: It is one of the examinations for cervical adhesion, to understand whether there is uterine cavity adhesion, determine the location, degree, and tissue of adhesion. The characteristics of each group of adhesions are: the endometrial adhesion is very similar to the surrounding endometrium; the characteristic is that there is a thin layer of endometrium covering the surface, with many gland orifices on the surface; while the adhesion of connective tissue has no endometrial formation on the surface.

　　Uterine Sound Examination: How to examine cervical adhesion? Experts point out that resistance can vary depending on the type of adhesion tissue, the uterine cavity probe is easy to insert; it requires a little force to insert the probe; when the tissue feels tough and the probe is not easy to insert, do not use force blindly. After the probe enters the uterine cavity, it can sweep the cavity obliquely to the left and right to test the range of adhesion. Severe adhesions may feel like the uterine cavity is a narrow tube, with a very small range of probe movement.

　　子宫碘油造影：官腔粘连的子宫，官腔与宫颈影象往往重叠不清，子宫呈橄榄形。用宫颈钳牵引宫颈，使子宫伸展，子宫影象从橄榄形变成三角形。

　　Dietary Taboos for Patients with Cervical Adhesions

　　Conventional Methods of Western Medicine for Treating Cervical Adhesions

　　Although hysteroscopy can effectively treat cervical adhesion infertility, early detection of this disease is very important. Therefore, when women experience abnormal menstruation or reproductive dysfunction, they should pay attention and seek medical attention in a timely manner. The application of hysteroscopy in clinical practice not only can determine the degree and type of adhesions, but also can determine the tenacity of adhesions.

　　For membrane adhesions and fibromuscular adhesions, they can be separated under hysteroscopy or removed by surgical scissors; for dense adhesions similar to connective tissue, electrocautery separation surgery is required under B-ultrasound guidance, and an intrauterine device is placed postoperatively to prevent re-adhesion. Continuous medication with estrogen and progesterone is given to promote endometrial growth. This allows the patient to recover menstruation, and some patients can become pregnant again.