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Cesarean scar

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https://www.readbyqxmd.com/read/29159943/retrospective-multicenter-study-of-leaving-the-placenta-in-situ-for-patients-with-placenta-previa-on-a-cesarean-scar
#1
Kei Miyakoshi, Toshimitsu Otani, Eiji Kondoh, Shintaro Makino, Mamoru Tanaka, Satoru Takeda
OBJECTIVE: To investigate maternal outcomes after leaving the placenta in situ for placenta accreta spectrum (PAS) disorders in patients with placenta previa on a cesarean delivery scar. METHODS: The present retrospective study reviewed medical records from women with placenta previa on a cesarean scar underwent perinatal care at secondary- or tertiary-level perinatal centers in Japan between January 1, 2010, and December 31, 2014. Perinatal management was conducted based on each leading obstetrician's discretion...
November 21, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29147816/development-of-pseudoaneurysm-in-cesarean-section-scar-pregnancy-a-case-report-and-literature-review
#2
Shunki Kiyokawa, Tatsuyuki Chiyoda, Kazunori Ueno, Keiko Saotome, Seon-Hye Kim, Sakura Nakada
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. It is becoming more common, but it can lead to uterine rupture and severe hemorrhage. Here, we report a case of a 37-year-old woman with CSP complicated with pseudoaneurysm. The pseudoaneurysm emerged following focal injection of methotrexate (MTX) and potassium chloride with systemic MTX treatment. Due to a risk of sudden bleeding, uterine artery embolization (UAE) was recommended, but the patient hoped to avoid this if possible. Because the serum human chorionic gonadotropin level and the gestational sac were still persistent, dilation and curettage were performed with interventional radiologists on standby...
November 16, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29130675/-severe-adverse-pregnancy-outcomes-in-placenta-previa-and-prior-cesarean-delivery
#3
Mi Zhou, Meng Chen, Li Zhang, Guo-Lin He, Lei He, Qiang Wei, Tao Li, Xing-Hui Liu
OBJECTIVE: To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. METHODS: This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29105214/re-risk-of-cesarean-scar-defect-following-single-vs-double-layer-uterine-closure-systematic-review-and-meta-analysis-of-randomized-controlled-trials-a-di-spiezio-sardo-g-saccone-r-mccurdy-e-bujold-g-bifulco-and-v-berghella-ultrasound-obstet-gynecol-2017-50
#4
COMMENT
https://www.readbyqxmd.com/read/29095305/umbilical-cord-mesenchyme-stem-cell-local-intramuscular-injection-for-treatment-of-uterine-niche-protocol-for-a-prospective-randomized-double-blinded-placebo-controlled-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Dazhi Fan, Shuzhen Wu, Shaoxin Ye, Wen Wang, Xiaoling Guo, Zhengping Liu
BACKGROUND: Uterine niche is defined as a triangular anechoic structure at the site of the scar or a gap in the myometrium at the site of a previous caesarean section. The main clinical manifestations are postmenstrual spotting and intrauterine infection, which may seriously affect the daily life of nonpregnant women. Trials have shown an excellent safety and efficacy for the potential of mesenchymal stem cells (MSCs) as a therapeutic option for scar reconstruction. Therefore, this study is designed to investigate the safety and efficacy of using MSCs in the treatment for the uterine niche...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29062659/bilateral-free-flap-breast-reconstruction-outcomes-do-abdominal-scars-affect-bilateral-flaps
#6
Dmytro Unukovych, Edward J Caterson, Matthew J Carty, Jessica Erdmann-Sager, Eric Halvorson, Stephanie A Caterson
BACKGROUND: The incidence of bilateral mastectomies is increasing along with the rates of breast reconstructions. A substantial number of patients will present with abdominal scars after Cesarean section, laparoscopy, laparotomy, and so on. The aim of this study was to evaluate the impact of prior abdominal scars on complication rates in abdominal bilateral free flap breast reconstruction. METHODS: All consecutive patients with autologous free flap breast reconstruction between 2007 and 2014 were eligible...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29060964/-clinical-analysis-on-hysteroscopic-surgery-for-the-treatment-of-type-%C3%A2-cesarean-scar-pregnancy-in-the-first-trimester
#7
COMPARATIVE STUDY
Z Y Chen, X Y Li, D Zhao, M Zhou, P Xu, X F Huang, X M Zhang
Objective: To investigate the safety and efficacy of hysterosopic management of type Ⅱ cesarean scar pregnancy (CSP) and the value of prophylactic uterine artery embolization (UAE). Methods: Totally 104 patients with type Ⅱ CSP treated with hysteroscopic surgery at the Women's Hospital, School of Medicine, Zhejiang University, during Jan. 2009 to Jun. 2016 were analyzed retrospectively, 67 patients combined with UAE (UAE group) and 37 patients without combined with UAE (non-UAE group). Laparoscopy or sonography guidance was conducted simultaneously...
October 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29038043/laparoscopic-excision-of-a-scar-pregnancy-and-isthmocele-repair
#8
Huseyin Kiyak, Lale Susan Wetherilt, Kerem Doga Seckin, Ibrahim Polat, Pınar Kadirogullari, Tolga Karacan
Laparoscopic excision of a scar pregnancy and isthmocele repair with barbed suture Design Step by step explanation of the laparoscopic excision technique of a scar pregnancy and isthmocele repair Setting Cesarean scar pregnancy occurs as a result of attachment of the products of conception to the uterine scar. In the present case, a 34 year old G4 P1 patient with a history of one miscarriage and one ectopic pregnancy was diagnosed with type 2 cesarean scar pregnancy at 7 weeks of gestation. A Dilation & Curretage was performed at the 8th week of gestation to terminate the pregnancy...
October 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29024799/treatment-for-uterine-isthmocele-a-pouch-like-defect-at-the-site-of-cesarean-section-scar
#9
REVIEW
Antonio Setubal, João Alves, Filipa Osório, Adalgisa Guerra, Rodrigo Fernandes, Jaime Albornoz, Zacharoula Sidiroupoulou
Isthmocele appears as a fluid pouch-like defect in the anterior uterine wall at the site of a prior Cesarean section and ranges in prevalence from 19% to 84%, a direct relation to the increase in Cesarean sections performed worldwide. Many definitions have been suggested for the dehiscence resulting from Cesarean section, and we propose standardization with a single term for all cases: isthmocele. Patients are not always symptomatic, but symptoms typically include intermittent abnormal bleeding, pain, and infertility...
October 9, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29023142/diffusion-weighted-imaging-in-ectopic-pregnancy-ring-of-restriction-sign
#10
Afak Durur-Karakaya, Mehmet Seker, İrmak Durur-Subasi
OBJECTIVE: To demonstrate the diffusion-weighted imaging (DWI) findings of ectopic pregnancy (EP) and introduce the "ring of restriction" sign by discussing possible causes. METHODS: Between January 2014 and January 2017, patients with EP and examined by MRI on a 3T scanner were retrospectively evaluated. MRI and DWI findings were recorded. RESULTS: A total of 40 patients were diagnosed with EP at our university hospital, 8 of whom (20%) were evaluated by MRI and DWI...
October 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28961140/a-preliminary-study-of-uterine-scar-tissue-following-cesarean-section
#11
Cailin Wu, Xin Chen, Zhixiong Mei, Juan Zhou, Liangzhi Wu, Wei-Hsiu Chiu, Xiaomin Xiao
AIM: To compare smooth muscle cells, type I collagen, and apoptosis of the lower uterine segment of women who had/without a prior cesarean delivery. METHODS: Alpha smooth muscle actin (α-SMA), type I collagen, and nuclear apoptosis were compared between the groups from lower uterine segment. Twenty-eight controls and 82 with one prior cesarean delivery were included. The women with a prior cesarean section were classified by time since the surgery: ≤3 years, >3 and ≤5 years, >5 and ≤7 years, >7 and ≤9 years, and >9 years...
September 29, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28954447/-expectant-management-of-11-cases-of-cesarean-scar-pregnancy
#12
F He, J Q Li, X L Tang, Y Lin, C H Su, D J Chen
Objective: To explore the natural courses of 11 patients with cesarean scar pregnancy (CSP) with expectant management. Methods: Eleven patients with CSP who were diagnosed in the first trimester in the Third Affiliated Hospital of Guangzhou Medical University from January 2015 to March 2017 were recruited. All of them received expectant management. Nine pregnancies continued to the third trimester (the third trimester group), and 2 patients were expected to the second trimester (the second trimester group)...
September 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28932738/commentary-conservative-management-of-a-scar-abscess-formed-in-a-cesarean-induced-isthmocele
#13
COMMENT
Ekaterini Christina Tampaki, Athanasios Tampakis, Konstantinos Kontzoglou, Gregory Kouraklis
No abstract text is available yet for this article.
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28904664/-pregnancy-and-delivery-in-patients-with-a-personal-history-of-cesarean-section-in-dakar-epidemiological-clinical-therapeutic-and-prognostic-aspects
#14
Cyr Espérance Koulimaya-Gombet, Abdoul Aziz Diouf, Moussa Diallo, Anna Dia, Codou Sène, Jean Charles Moreau, Alassane Diouf
The aim of our study was to determine hospitalization rate for vaginal birth after cesarean section in Pikine, to evaluate the quality of the management of pregnant women with previous cesarean section and to determine prognostic factors of the outcome of a trial of scar. We conducted a retrospective study based on medical records and operational protocols of patients who underwent vaginal birth after cesarean section over the period 1 January 2010 - 31 December 2011. We analyzed socio-demographic data, pregnancy follow-up, therapeutic modalities and prognosis...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28893656/hysteroscopic-isthmoplasty-step-by-step-technique
#15
Attilio Di Spiezio Sardo, Brunella Zizolfi, Gloria Calagna, Pierluigi Giampaolino, Filomena Paolella, Giuseppe Bifulco
BACKGROUND: Isthmocele is a characteristic semi-diverticular anomaly of the anterior isthmic wall of the uterus, located at the site of a previous cesarean delivery scar. The etiopathogenesis of isthmocele is still poorly understood, and several hypotheses have been proposed. Possible factors that could play a role in niche development include a very low incision through cervical tissue, an inadequate suturing technique during the closure of the uterine scar surgical interventions that increase adhesion formation or patient-related factors that impair wound healing, or increase inflammation or adhesion formation...
September 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28892298/impact-of-hysteroscopic-surgery-for-isthmocele-associated-with-cesarean-scar-syndrome
#16
Shunichiro Tsuji, Fuminori Kimura, Akiyoshi Yamanaka, Tetsuro Hanada, Kimiko Hirata, Akie Takebayashi, Akiko Takashima, Ayumi Seko-Nitta, Takashi Murakami
AIM: Cesarean scar syndrome (CSS) is characterized by increased risk of postmenstrual abnormal uterine bleeding, dysmenorrhea, and infertility, due to a post-cesarean scar defect known as an isthmocele. This study aimed to assess the impact of hysteroscopic surgery on isthmocele associated with CSS. METHODS: Eighteen patients with CSS were enrolled. Surgical methods included resection of the inferior edge and superficial cauterization of the isthmocele via hysteroscopic surgery...
September 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28873371/modified-hysterotomy-closure-technique-for-open-fetal-surgery
#17
Michael V Zaretsky, Kenneth W Liechty, Henry L Galan, Nicholas J Behrendt, Shane Reeves, Ahmed I Marwan, Corbett Wilkinson, Michael Handler, Megan Lagueux, Timothy M Crombleholme
OBJECTIVE: We reviewed our experience with open fetal surgical myelomeningocele repair to assess the efficacy of a new modification of the hysterotomy closure technique regarding hysterotomy complication rates at the time of cesarean delivery. METHODS: A modification of the standard hysterotomy closure was performed on all patients undergoing prenatal myelomeningocele repair. The closure consisted of an interrupted full-thickness #0 polydioxanone (PDS) retention suture as well as a running #0 PDS suture to re-approximate the myometrial edges, and the modification was a third imbricating layer resulting in serosal-to-serosal apposition...
September 6, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28832909/longitudinal-transvaginal-ultrasound-evaluation-of-cesarean-scar-niche-incidence-and-depth-in-the-first-two-years-after-single-or-double-layer-uterotomy-closure-a-randomized-controlled-trial
#18
Christian Bamberg, Larry Hinkson, Joachim W Dudenhausen, Verena Bujak, Karim D Kalache, Wolfgang Henrich
INTRODUCTION: Cesarean deliveries are the most common abdominal surgery procedure globally, and the optimal way to suture the hysterotomy remains a matter of debate. The aim of this study was to assess the incidence of cesarean scar niches and the depth after single- or double-layer uterine closure. MATERIAL AND METHODS: We performed a randomized controlled trial in which women were allocated to three uterotomy suture techniques: continuous single-layer unlocked, continuous locked single-layer, or double-layer sutures...
August 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28829760/outcomes-of-laparoscopic-treatment-in-women-with-cesarean-scar-syndrome
#19
Erik Dosedla, Pavel Calda
BACKGROUND The aim of this study was to evaluate the outcomes of laparoscopic treatment of women with severe defect of a Cesarean section (CS) scar and Cesarean scar syndrome. MATERIAL AND METHODS A prospective longitudinal study was conducted in 11 women who were treated for Cesarean scar syndrome. Ultrasound examinations were performed transvaginally 1 day before surgery and 6 months after laparoscopy in all women. Clinical data were registered 1 day before laparoscopy and 6 months after laparoscopy. RESULTS Of these 11 women, total dehiscence of the CS scar was present in 72...
August 22, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28829510/clinical-outcomes-after-resectoscopic-treatment-of-cesarean-induced-isthmocele-a-prospective-case-control-study
#20
L Muzii, L Domenici, F Lecce, M Di Feliciantonio, R Frantellizzi, C Marchetti, M Monti, P Benedetti Panici
OBJECTIVE: Isthmocele represents a reservoir on the anterior wall of the uterine isthmus or of the cervical canal at the site of a previous cesarean delivery scar. Recently, it has been clarified that it might be the cause of several gynecologic symptoms, as most common abnormal uterine bleeding. Hysteroscopy and trans-vaginal ultrasound are considered the gold standard for the diagnosis of this defect. Resectoscopic treatment can be considered effective in small size defects, but no randomized clinical trials are available...
August 2017: European Review for Medical and Pharmacological Sciences
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