What are the risks associated with a uterine synechia (uterine adhesion) or a fibrous uterine band during pregnancy?

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Last updated: May 9, 2025View editorial policy

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From the Research

Fibrous uterine bands can pose a significant risk to pregnancy, particularly if they affect the expansion of the uterus, and close monitoring is essential to prevent complications such as preterm labor or placental abruption. The danger level of fibrous uterine bands during pregnancy varies significantly between patients, depending on their location, size, and number. These bands can potentially restrict fetal movement, cause abnormal fetal positioning, interfere with placental development, or in severe cases, lead to pregnancy complications such as intrauterine growth restriction, preterm labor, or placental abruption 1.

Key Considerations

  • The most concerning scenario is when these adhesions affect the expansion of the uterus as pregnancy progresses.
  • Close monitoring through regular prenatal visits is essential for women with uterine adhesions who are pregnant or planning pregnancy.
  • More frequent ultrasounds may be recommended to monitor fetal growth and development.
  • In some cases, surgical removal of adhesions through hysteroscopy may be recommended before pregnancy to improve outcomes 2.

Management and Prevention

  • The underlying cause of these adhesions, often previous uterine surgeries like D&Cs or cesarean sections, can help predict their potential impact on pregnancy.
  • Routine use of fetal fibronectin testing and transvaginal ultrasound for cervical length measurement can help identify women at risk of preterm labor 3.
  • Written protocols for preterm labor triage should be available and consistently followed to ensure timely and effective management 3.

Recommendations

  • Women with fibrous uterine bands should be closely monitored during pregnancy to prevent complications.
  • Healthcare providers should recommend more frequent ultrasounds and consider surgical removal of adhesions before pregnancy if necessary.
  • Routine use of fetal fibronectin testing and transvaginal ultrasound can help identify women at risk of preterm labor, and written protocols for preterm labor triage should be consistently followed 1, 3.

References

Research

Availability and use of fetal fibronectin testing and transvaginal ultrasound for preterm labor evaluation in the United States.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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