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Cesarean scar

John DeMeritt, Ethan Wajswol, Anoop Wattamwar, Babak Litkouhi, Ami Vaidya, Michael Sbarra, Stacy Zamudio, Rocio Acera Pozzi, Andrew Canning, John Woytanowski, Abdulla Al-Khan
Two patients with placenta percreta underwent uterine artery embolization (UAE) for abnormally invasive placenta (AIP) in the first trimester. Patient 1 had a 9-week cervical ectopic, while Patient 2 had a 9-week cesarean scar pregnancy. Elective termination of pregnancy was performed in both patients. UAE was performed with tris-acryl gelatin microspheres as well as gelfoam until stasis and was repeated in cases of revascularization. Both patients were followed with US/MRI/MRA scans and β-hCG levels. Revascularization occurred in both patients following UAE, requiring multiple embolizations to achieve complete placental involution...
March 19, 2018: Cardiovascular and Interventional Radiology
Amartuvshin Tumenjargal, Hiroyuki Tokue, Hiroshi Kishi, Hiromi Hirasawa, Ayako Taketomi-Takahashi, Yoshito Tsushima
PURPOSE: To investigate the efficacy and safety of uterine artery embolization (UAE) followed by dilation and curettage (D&C) as a treatment for cesarean scar pregnancy (CSP) and to assess pregnancy outcomes after the treatment. MATERIALS AND METHODS: We retrospectively analyzed 33 CSP patients treated with UAE followed by D&C. The serum level of beta human chorionic gonadotropin (β-hCG) normalization, hospitalization, menstruation, and successful pregnancy after treatment was assessed as clinical and pregnancy outcomes...
March 15, 2018: Cardiovascular and Interventional Radiology
Fatimah Alnafisah, Shaimaa K Dawa, Sherif Alalfy
Cutaneous endometriosis is one of the rare gynecological conditions. Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity. It commonly occurs in pelvic sites, such as the ovaries, cul-de-sac, bowel, or pelvic peritoneum. Endometriosis at the incisional scar is difficult to diagnose because of nonspecific symptoms. Usually, patients complain of pain at the site of the incision during menstruation. The main causes in most of the reported cases are obstetrical and gynecological surgeries...
January 13, 2018: Curēus
Dazhi Fan, Qing Xia, Shuzhen Wu, Shaoxin Ye, Li Liu, Wen Wang, Xiaoling Guo, Zhengping Liu
BACKGROUND: Cesarean delivery has already become a very common method of delivery around the world, especially in low-income countries. Hypertrophic scars and wound infections have affected younger mothers and frustrated obstetricians for a long time. Mesenchymal stem cells (MSCs) have strong potential for self-renewal and differentiation to multilineage cells. Previous studies have demonstrated that MSCs are involved in enhancing diabetic wound healing. Therefore, this study is designed to investigate the safety and efficacy of using MSCs in the treatment of Cesarean section skin scars...
March 2, 2018: Trials
Ling Gao, Yan-Yan Hou, Feng Sun, Wei Xia, Yi Yang, Tian Tian, Qin-Fang Chen, Xiao-Cui Li
PURPOSE: The study aimed to compare the efficacy of intra-arterial methotrexate (MTX) infusion combined with uterine artery embolisation (UAE) and uterine curettage with that of UAE and curettage without MTX infusion for the treatment of cesarean scar pregnancy (CSP). METHODS: In this retrospective study, data of CSP patients admitted from January 2011 to July 2015 were obtained from electronic patient records. Clinical information at baseline and after treatment were extracted and analyzed...
March 1, 2018: Archives of Gynecology and Obstetrics
Ge'er Zhang, Zimin Pan
OBJECTIVE: To analyze the clinical features, diagnosis and treatment of gestational trophoblastic diseases in cesarean scar. METHODS: Clinical data of three cases of gestational trophoblastic diseases in cesarean scar diagnosed in Women's Hospital, Zhejiang University School of Medicine during December 2011 and December 2016 were collected. And literature search was performed in Wanfang data, VIP, CNKI, PubMed, ISI Web of Knowledge and EMbase database. RESULTS: A total of 20 cases of gestational trophoblastic diseases were included in the analysis...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Murat Ekin, Hediye Dagdeviren, Sema Suzen Caypinar, Bilgen Erdogan, Mehmet Emin Ayag, Huseyin Cengiz, Levent Yasar, Çaglar Helvacioglu
OBJECTIVE: To compare the cosmetic result of the PEAK Plasma Blade with traditional scalpel in patients who had primary cesarean delivery by using POSAS (Patient and Observer Assessment Scale). MATERIAL AND METHODS: Fourty women between 20 and 40 years, who were planning to have primary cesarean delivery, were randomized for skin incision with PEAK Plasma Blade (n:20) and with scalpel (n:20) were blinded to their group allocation. At six months, the cosmetic outcome of the cesarean scar was assessed using the POSAS...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Qiu-Lei Sun, Xiao-Hua Wu, Li Luo, De-Mei Ying, Ying Yang, Zheng-Qiong Chen
PURPOSE: To explore the efficacy of treatment for early cesarean scar pregnancy (CSP) and to evaluate the characteristics of women with subsequent mixed mass formation. METHODS: Women with CSP, who received UACE followed by evacuation, were retrospectively analyzed. Clinical/sonographic characteristics in patients with or without mixed mass formation were compared. RESULTS: From a total of 395 cases, 105 cases had a pregnancy residual with mixed mass formation...
February 15, 2018: Archives of Gynecology and Obstetrics
Wancheng Zhao, Guipeng Liu, Qing Yang, Chunmei Zhang
OBJECTIVE(S): To introduce a new method using a Foley catheter to locate the diverticulum in laparoscopic repair of uterine cesarean scar defect (CSD), and to evaluate the gynecological outcomes and prognosis of this new procedure. STUDY DESIGN: Twelve patients with abnormal uterine bleeding or future fertility requirements opted for the laparoscopic repair of CSD. Then we present a series of photographic images before and after placement of the Foley catheter, and their clinical data to evaluate this new surgical technique...
February 8, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Tina A Nguyen, Daniel A Kahn, Andrea I Loewendorf
INTRODUCTION: Maternal-fetal chimerism is miniscule, a testament to the integrity of the uteroplacental interface. The soundness of this border region is potentially altered through cesarean delivery of prior babies with uncertain consequences for the following pregnancies. METHODS: Using multicolor flow cytometry and quantitative PCR of non-inherited maternal antigens we performed a retrospective case control pilot study and formulated the null hypothesis that placental implantation over a prior uterine scar does not result in the presence of memory Treg (CD45RO+) in the fetus...
February 12, 2018: Immunity, Inflammation and Disease
Mark P Hehir, Dwight J Rouse, Russell S Miller, Cande V Ananth, Jason D Wright, Zainab Siddiq, Mary E DʼAlton, Alexander M Friedman
OBJECTIVE: To characterize probabilities of vaginal delivery based on second-stage duration along with maternal and neonatal risks for women undergoing labor after cesarean delivery. METHODS: This unplanned secondary analysis of the Maternal-Fetal Medicine Units Cesarean Registry, a prospective observational cohort, assessed outcomes in women with a prior uterine scar and included women with a previous cesarean delivery without prior vaginal delivery who reached the second stage of labor...
March 2018: Obstetrics and Gynecology
Shashikant L Sholapurkar
There is an increasing incidence of cesarean scar (CS) defect/niche and its sequelae, probably not entirely explained by better diagnosis or rising cesarean rate. Discussion of possible etiological factors has received scant attention but would be important to formulate preventive strategies. Meaningful informative studies on long-term sequelae of cesarean section are very difficult and none are available for causation of CS defect. Hence, it is crucial to identify key areas in etiology of CS defect for focused research...
March 2018: Journal of Clinical Medicine Research
Shirin Torabi, Mahdi Sheikh, Farzaneh Fattahi Masrour, Alireza A Shamshirsaz, Zhoobin H Bateni, Ahmed A Nassr, Parichehr Pooransari, Marzieh Talebian, Sedigheh Hantoushzadeh
OBJECTIVES: To assess the effects of previous cesarean delivery (CD) and placental location on second trimester uterine artery Doppler indices in subsequent pregnancy and to assess the predictive values of abnormal Doppler findings for adverse pregnancy outcomes in women with previous CD. STUDY DESIGN: This prospective cohort study evaluated 400 gravida two pregnant women (200 with previous none medically indicated CD and 200 with previous normal vaginal deliveries (NVD)) who were referred for second trimester fetal anatomic survey...
February 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
Nur Betül Tekiner, Berna Aslan Çetin, Lale Susan Türkgeldi, Gökçe Yılmaz, İbrahim Polat, Ali Gedikbaşı
BACKGROUND: We aimed to determine if there is a difference in the size of the cesarean scar defect using saline infusion sonography (SIS) performed on the postoperative third month in patients who underwent single- or double-layered unlocked closure of their uterine incision during their first cesarean delivery. METHODS: This study was conducted as a prospective cross-sectional study between February 2015 and January 2016 in patients admitted to the labour ward of the Kanuni Sultan Suleyman Training and Research Hospital who subsequently underwent their first delivery by cesarean section...
February 3, 2018: Archives of Gynecology and Obstetrics
Jian Qiu, Yunfeng Fu, Xiaohong Huang, Longwen Shu, Jiewei Xu, Weiguo Lu
Uterine artery embolization (UAE) is considered to be an effective treatment for patients with cesarean scar pregnancy, especially for those presenting uncontrollable hemorrhage. However, it can also cause some potential complications. Pulmonary embolism is a rare but fatal complication in patients treated with UAE. Here, we report a case of a woman who was diagnosed with cesarean scar pregnancy presenting with pulmonary embolism during the operation of dilation and curettage after UAE treatment. Prompt resuscitation was carried out and the patient received anticoagulant treatment immediately...
2018: Therapeutics and Clinical Risk Management
Leonor Alamo, Yvan Vial, Alban Denys, Gustav Andreisek, Jean-Yves Meuwly, Sabine Schmidt
Although the World Health Organization suggests 10-15% as the adequate cesarean delivery rate to assure optimal prognosis for mother and children, cesarean rates have continuously increased worldwide over the last three decades, even in primiparous women. Moreover, uterine scars after myomectomies, complications of obstetrical interventions and more recently, after fetal surgery, are often observed. This review article describes the most commonly seen complications related to prior uterine scars and discusses their imaging findings, with emphasis on the increasing role of Magnetic Resonance Imaging for diagnosis...
2018: European Journal of Radiology Open
Elif Gülşah Dağdeviren, Rıza Dur, Erdem Fadıloğlu, Erhan Demirdağ, Çağatayhan Öztürk, Metin Altay
Cesarean scar ectopic pregnancies and molar pregnancies are two very rare obstetric pathologies. In both cases, serious morbidities are involved that require careful management. The coexistence of the two clinical conditions is far less common and there are a limited number of cases in the literature. In this case report, a 34-year-old patient with previous cesarean section was diagnosed as having a molar pregnancy in a cesarean scar through ultrasonography. The patient was asymptomatic at that time. Ultrasonography revealed a protruding mass at the cesarean section and her human chorionic gonadotropin level was measured as 59...
December 2017: Turkish journal of obstetrics and gynecology
L Zhao, H Yang, B R Ma, Z H Yin
Objectives: To evaluate the value of hysteroscopy in the diagnosis and treatment of cesarean scar pregnancy (CSP) incomplete abortion. Methods: A total of 42 patients with incomplete cesarean circumcision from January 2014 to March 2017 were retrospectively analyzed.Twenty-one patients underwent bilateral uterine artery embolization.Twenty patients underwent hysteroscopy Electrocardiose resection of pregnancy tissue and coagulation hemostasis, the control group of 22 patients underwent conventional uterine artery embolization surgery...
January 16, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Young Ran Kim, Myoung Jin Moon
Objective: To assess the efficacy and safety of ultrasound-guided intragestational injection of methotrexate (MTX) and systemic intramuscular MTX in the management of cesarean scar pregnancies. Methods: This was a retrospective case-control study that included women diagnosed with cesarean scar pregnancy at CHA Bundang Medical Center unit between 2009 and 2015. The 26 cases were managed with local injection of MTX under ultrasound guidance and 15 cases were treated with systemic intramuscular of MTX...
January 2018: Obstetrics & Gynecology Science
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