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Cesarean scar

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https://www.readbyqxmd.com/read/28721061/clinical-and-ultrasound-parameters-in-prediction-of-excessive-hemorrhage-during-management-of-cesarean-scar-pregnancy
#1
Ting Gui, Ping Peng, Xinyan Liu, Li Jin, Weilin Chen
PRECIS: During the management of cesarean scar pregnancy, gestational mass size >6 cm, uterine scar thickness <0.2 cm, peak systolic velocity >70 cm/s, and resistance index <0.35 are independent risk factors for excessive hemorrhage. OBJECTIVE: The objective of this study was to investigate risk factors associated with excessive hemorrhage during the management of cesarean scar pregnancy (CSP). PATIENTS AND METHODS: A retrospective case-control study was conducted, including 40 patients who experienced excessive bleeding and 80 controls without severe hemorrhage...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28682420/comparison-of-transvaginal-surgery-and-methotrexate-mifepristone-combined-transcervical-resection-in-the-treatment-of-cesarean-scar-pregnancy
#2
Y-Y Li, Z-Y Yin, S Li, H Xu, X-P Zhang, H Cheng, L Du, X-Y Zhou, B Zhang
OBJECTIVE: To explore the safety and efficiency of transvaginal surgical treatment of cesarean scar pregnancy (CSP). PATIENTS AND METHODS: A retrospective analysis of 54 CSP patients that received treatment in our hospital from October 2011 to September 2015 was performed, dividing two groups: Group A (n=34) received transvaginal cesarean scar pregnancy focus clearance surgery while Group B (n=20) received transcervical resection following methotrexate/mifepristone-combined treatment...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28670032/cesarean-scar-ectopic-pregnancy-invasion-of-the-bladder-wall-detected-by-magnetic-resonance-imaging
#3
Nelson Marcio Gomes Caserta, Angela Maria Bacha, Oswaldo R Grassiotto
Although cesarean scar ectopic pregnancy continues to be the rarest form of ectopic pregnancy, its incidence is increasing because of the worldwide increase in the number of cesarean deliveries. If the diagnosis is delayed, there is a high risk of severe hemorrhage and death, whereas early diagnosis can minimize the complications associated with the condition. Here, we report a case in which invasion of the bladder wall was identified by magnetic resonance imaging.
May 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/28668435/magnetic-resonance-imaging-in-tubal-and-non-tubal-ectopic-pregnancy
#4
REVIEW
Sitthipong Srisajjakul, Patcharin Prapaisilp, Sirikan Bangchokdee
Ectopic pregnancy is the leading cause of pregnancy-related death in the first trimester. Ectopic pregnancy is usually diagnosed by clinical, laboratory, and sonographic findings, with implantation most commonly located in the ampullary part of the fallopian tube. However, pregnancies that develop at unusual implantation sites, such as angular, interstitial, cornual, cervical, ovarian, cesarean scar, and abdominal cavity pregnancies, may rarely occur. Although ultrasound is considered the primary pregnancy-related imaging modality, it may not be able to illustrate the implantation site in certain types of pregnancy...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28661021/outcome-of-cesarean-scar-pregnancy-a-systematic-review-and-meta-analysis
#5
REVIEW
Giuseppe Calì, Ilan E Timor-Trisch, Josè Palacios-Jaraquemada, Ana Monteaugudo, Danilo Buca, Francesco Forlani, Alessandra Familiari, Giovanni Scambia, Ganesh Acharya, Francesco D'Antonio
OBJECTIVE: To explore the outcome of women managed expectantly following a diagnosis of caesarean scar pregnancy (CSP). METHODS: The outcomes observed were: severe first trimester vaginal bleeding, clinical symptoms (abdominal pain, vaginal bleeding) requiring treatment, uncomplicated miscarriage, complicated miscarriage requiring intervention, first or second trimester uterine rupture, first or second trimester hysterectomy, third trimester bleeding, third trimester uterine rupture, third trimester hysterectomy, maternal death, occurrence of abnormally invasive placenta (AIP), prevalence of placenta percreta, ultrasound signs suggestive of AIP, liveborn fetuses...
June 29, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28640149/analysis-of-risk-factors-for-intraoperative-hemorrhage-of-cesarean-scar-pregnancy
#6
Yan Ma, Minfang Shao, Xiaonan Shao
The current commonly used treatments for cesarean scar pregnancy (CSP) include multiple treatments such as medication, uterine artery embolization, curettage and surgery, and their combinations. However, every treatment option has risks of excessive hemorrhage from uterus. In this study, we retrospectively analyzed the risk factors for intraoperative hemorrhage of different treatments for CSP patients, with the hope to provide the guidance for CSP treatment.Fifty-eight cases of CSP patients who were treated with curettage after medication, curettage after uterine artery embolization, or surgery were retrospectively analyzed and compared for the clinical efficacy, length of hospital stay, and hemorrhage rate...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637058/evaluation-of-cases-of-abdominal-wall-endometriosis-at-universidade-estadual-de-campinas-in-a-period-of-10-years
#7
Daniela Angerame Yela, Lucas Trigo, Cristina Laguna Benetti-Pinto
Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE...
June 21, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28634752/comparison-of-three-treatment-strategies-for-cesarean-scar-pregnancy
#8
Guangquan Liu, Jiacong Wu, Jian Cao, Yunping Xue, Chencheng Dai, Juan Xu, Xuemei Jia
PURPOSE: To explore the optimal treatment for cesarean scar pregnancy. METHOD: In total, 86 women diagnosed with a cesarean scar pregnancy were divided into three groups according to treatment. The human chorionic gonadotrophin (hCG) decline percentage, intraoperative blood loss and success rate were analyzed in Group A [combination of uterine arterial embolization (UAE), local methotrexate (MTX) injection and dilation & curettage (D&C)], Group B (combination of UAE and local MTX injection) and Group C (D&C)...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28631355/quantitative-risk-assessment-to-guide-the-treatment-of-cesarean-scar-pregnancy
#9
Qingxian Fang, Li Sun, Yunhui Tang, Cuifeng Qian, Xiaoying Yao
OBJECTIVE: To develop a risk-factor scoring system for the prediction of bleeding during ultrasound-guided dilation and curettage (D&C) for cesarean scar pregnancy (CSP). METHODS: The retrospective study included patients with a CSP of 31-67 days who underwent transabdominal ultrasound-guided D&C in 2010-2014. Binary logistic regression analysis was used to identify risk factors for the need of Foley catheter hemostasis. The predictive accuracy of a risk-scoring system based on significant factors was evaluated by receiver operating curve analysis...
June 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28612958/clinical-characteristics-and-salvage-management-of-persistent-cesarean-scar-pregnancy
#10
Xue Ying, Wei Zheng, Li Zhao, Mi Zhou, Zhengyun Chen
AIM: The study was conducted to illustrate the clinical characteristics and treatment outcomes of patients with persistent cesarean scar pregnancy (PCSP). METHODS: During a six-year period, 38 cases of PCSP were diagnosed and treated conservatively to preserve fertility. The clinical presentations, imaging findings and treatment outcomes of these patients were reviewed. RESULTS: Fourteen out of 38 women (37%) presenting with PCSP suffered heavy vaginal bleeding...
June 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28599886/cesarean-scar-pregnancies-a-systematic-review-of-treatment-options
#11
REVIEW
Sarah Maheux-Lacroix, Ms Fiona Li, Emmanuel Bujold, Erin Nesbitt-Hawes, Rebecca Deans, Jason Abbott
The objective of this systematic review is to assess the efficacy and safety of treatment options of cesarean scar pregnancies (CSP). We searched Medline, Embase, and Cochrane Library from inception to June 2016 as well as reference lists. We included English publications reporting treatment outcomes of at least 10 cases of CSP. Two authors screened for eligibility, extracted data and assessed the quality of included studies. Treatment was considered successful if no subsequent intervention was required following index treatment...
June 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28598911/the-minimally-invasive-approach-to-the-symptomatic-isthmocele-what-does-the-literature-say-a-step-by-step-primer-on-laparoscopic-isthmocele-excision-and-repair
#12
Sevgi Sipahi, Kirsten Sasaki, Charles E Miller
PURPOSE OF REVIEW: The purpose of this review is to understand the minimally invasive approach to the excision and repair of an isthmocele. RECENT FINDINGS: Previous small trials and case reports have shown that the minimally invasive approach by hysteroscopy and/or laparoscopy can cure symptoms of a uterine isthmocele, including abnormal bleeding, pelvic pain and secondary infertility. A recent larger prospective study has been published that evaluates outcomes of minimally invasive isthmocele repair...
August 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28595646/evaluation-of-obstetricians-surgical-decision-making-in-the-management-of-uterine-rupture
#13
Justus Ndulue Eze, Okechukwu Bonaventure Anozie, Osaheni Lucky Lawani, Emmanuel Okechukwu Ndukwe, Uzoma Maryrose Agwu, Johnson Akuma Obuna
BACKGROUND: Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. This study aims to evaluate obstetricians' perspectives on surgical decision making in managing uterine rupture. METHODS: A questionnaire-based cross-sectional study of obstetricians at the 46th annual scientific conference of Society of Gynaecology and Obstetrics of Nigeria in 2012...
June 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28590029/treatment-of-heterotopic-caesarean-scar-pregnancy-complicated-with-post-termination-increase-in-size-of-residual-mass-and-morbidly-adherent-placenta
#14
Andre Hadyme Miyague, Adriano Pienaro Chrisostomo, Sergio Luis Costa, Edson Tetsuya Nakatani, William Kondo, Claudio Corrêa Gomes
We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining "mass" increased in size threefold and was surrounded by a rich vascular network. An arteriovenous malformation was suspected; however, appropriate treatment was precluded because of the viability of the ectopic gestation. Sonographic examination revealed a morbidly adherent placenta, and attempt to resect the mass laparoscopically was complicated by bleeding that required hysterectomy...
June 7, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28589479/risk-factors-for-incomplete-healing-of-the-uterine-incision-after-cesarean-section
#15
Yan Chen, Ping Han, Yi-Jia Wang, Yan-Xia Li
OBJECTIVE: To analyze related risk factors of post-cesarean scar defects (PCSDs). METHODS: A retrospective study of full-term women delivered by cesarean with singleton infants at our hospital from April 2014 to December 2015 was performed. 69 cases of diagnosed PCSDs and 107 cases with no PCSD who accepted cesarean were recruited for analysis. Individual medical case and operative report review were retrieved for maternal clinical characteristics analysis. RESULTS: There was no difference in age, gestational age, BMI and baby's weight between the two groups...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28576692/utero-abdominal-wall-fistula-after-cesarean-section-in-patient-with-prior-colorectal-resection-for-endometriosis-case-report-and-systematic-review
#16
Chloé Chattot, Patrick Aristizabal, Sofiane Bendifallah, Emile Daraï
Utero-Abdominal Wall Fistula (UAWF) is a very rare complication of cesarean section. We report an unusual case of a UAWF occurring in a 37-year-old woman, 4 years after a cesarean section and previously radical surgery for deep infiltrating endometriosis (DIE) with bowel resection. The patient presented with persistent purulent discharge of the Pfannenstiel scar and had noted that the discharge was blood-stained during menstruation. Magnetic resonance imaging confirmed the diagnosis of UAWF. Surgery was performed by laparotomy and was complicated by a postoperative rectovaginal fistula (RVF) which was successfully treated by the placement of a biological mesh via the vagina route...
May 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28546659/cesarean-scar-pregnancy-some-management-options
#17
EDITORIAL
Chandrashekhar V Hegde
No abstract text is available yet for this article.
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28511577/sonographic-assessment-of-the-lower-uterine-segment-during-active-labor-in-women-with-or-without-a-uterine-scar-a-prospective-study
#18
Eran Barzilay, Amir Shay, Hila Lahav-Ezra, Avi Shina, Sharon Perlman, Reuven Achiron, Yinon Gilboa
OBJECTIVES: No study thus far has evaluated the LUS thickness in active labor. In this study we endeavored to assess the LUS during active labor. METHODS: Using transabdominal sonography in the mid-sagittal position with a full urinary bladder, the thickness of the LUS was measured during active labor phase in women with or without a history of a previous cesarean section. RESULTS: A total of 28 women with a previous cesarean delivery were compared to 29 women without a history of uterine surgery...
May 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28509317/morphology-of-the-cesarean-section-scar-in-the-non-pregnant-uterus-after-one-elective-cesarean-section
#19
Michał Pomorski, Tomasz Fuchs, Anna Rosner-Tenerowicz, Mariusz Zimmer
OBJECTIVES: A growing number of studies suggest that the incomplete healing of the CS scar in the uterus increase the risk of uterine dehiscence or rupture during subsequent pregnancies. Thus, the factors that affect wound healing should be evaluated. We aimed to determine whether the morphology of the CS scar in non-pregnant women after one elective CS was affected by the site of the uterine incision, uterine flexion, maternal age, and fetal birth weight. MATERIAL AND METHODS: 208 non-pregnant women were invited for participation in the study, but only 101 of them met inclusion criteria...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28500899/hysteroscopy-in-the-treatment-of-uterine-cesarean-section-scar-diverticulum-a-systematic-review
#20
REVIEW
Anna Abacjew-Chmylko, Dariusz G Wydra, Hanna Olszewska
The aim of this paper is to review and to analyze the results of previous studies dealing with hysteroscopic treatment of postcesarean scar defects. A systematic review of publications indexed in MEDLINE/PubMed database identified a total of 11 studies dealing with resectoscopic treatment of postcesarean scar defect. The review was conducted in line with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and the PRISMA statement. In only few studies, patients were qualified for hysteroscopic surgery based on the measurement of the defect depth and thickness of residual myometrium above the pouch...
May 10, 2017: Advances in Medical Sciences
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