<prompt> Ashermans syndrome can be diagnosed by all except:HysterosalpingographySaline sonographyEndometrial cultureHysteroscopy  <response>: Ans. is c, i.e. Endometrial cultureRef: Williams Gynae 1sted, p420; Leon Speroff 7thed, p419Ashermans syndrome: It is an acquired uterine defect characterized by the presence of uterine synechiaes and subsequent destruction of the lining endometrium. MC cause for asherman syndrome -Postpartum curettage 2nd MC cause - curettage done for MTP Other causes - uterine surgery like cesarean section, myomectomy, Sheehans syndrome Infectious causes - TB, Schistosomiasis Most characteristic symptom Hypomenorrhea scanty bleeding 20ml or 2 days or 2deg amenorrhea Others - Infertility Abortion Diagnosis: ... Williams Gynae 1sted, p420-l When Asherman syndrome is suspected, HSG is indicated. Intrauterine adhesions, characteristically appear as irregular, angulated filling defects within the uterine cavity. At times, uterine polyps, leiomyomas, air bubbles and blood clots may masquerade as adhesions. Transvaginal USG or saline infusion sonography may help clarify these difficult cases. A definitive diagnosis requires hysteroscopy. Investigation of choiceTreatment: Adhesiolysis via hysteroscopy. Placement of an intrauterine device or Pediatric foleys catheter with the bulb filled with 3ml of fluid, to avoid contact between the ends of the adhesions. Treatment with estrogen to stimulate endometrial growth. Since estrogen alone can lead to endometrial, cancer. Estrogen and progesterone should be given together.Prognosis: Approximately 70-80 of patients with this condition have achieved successful pregnancy. But pregnancy can be complicated by premature labor, placenta accreta, placenta previa andor PPH. Recurrence rate is high. 