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Cesarean scar

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28825957/the-effect-of-tranilast-8-liposomal-gel-versus-placebo-on-post-cesarean-surgical-scars-a-prospective-double-blind-split-scar-study
#8
RANDOMIZED CONTROLLED TRIAL
Libi Kohavi, Eli Sprecher, Eyal Zur, Ofir Artzi
BACKGROUND: Tranilast (N-[3, 4-dimethoxycinnamoyl] anthranilic acid), an antiallergic drug, has been shown to attenuate scar formation possibly through inhibition of transforming growth factor beta 1 activity and consequent suppression of collagen synthesis in fibroblasts. OBJECTIVE: The authors aimed at evaluating the efficacy and safety of tranilast 8% gel in improving the appearance and symptoms of new post-cesarean section surgical wounds. METHODS: In this prospective double-blind split-scar study, the authors treated each half scar of 26 women with either tranilast 8% liposomal gel or tranilast-free liposomal gel (placebo)...
September 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28820418/pathological-adherence-of-placenta-case-reports
#9
R Sulukhia, L Melia, N Pirtskhalava, A Sukhiashvili
Major obstetric hemorrhage is the leading cause of maternal morbidity and mortality. In rare cases, life-threatening hemorrhage in pregnant women may result from abnormal adherence of placenta. Three grades of abnormal placental attachment are defined according to the depth of invasion: placenta accreta, placenta increta, and placenta percreta. An important risk factor for placenta abnormal adherence of placenta is placenta previa in the presence of a uterine scar. The increased prevalence of cesarean section, uterine surgery, and increasing parturient age and parity have led to an increased incidence of abnormal placentation, from one in 2,500 a quarter century ago, to one in 533 deliveries currently...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28797151/-comparison-of-the-safety-of-two-treatment-methods-of-cesarean-scar-pregnancy-of-type%C3%A2-and-%C3%A2-in-menopause-within-7-weeks
#10
X Y Wei, X L Yu
Objective: To comparison of the safety of two treatment methods of cesarean scar pregnancy (CSP) of typeⅡ and Ⅲ in menopause within 7 weeks. Methods: Totally 70 cases of CSP of typeⅡ and Ⅲ within 7 weeks of the last menstrual period, hospitalized within Peking University First Hospital from January 2009 to May 2016, had been retrospectively studied in two groups of different treatments. The methotrexate (MTX) treatment group included 37 cases receiving ultrasound-guided complete curettage of uterine cavity combined with MTX therapy, while the uterine artery embolization (UAE) group had 33 cases treated with UAE combined with MTX therapy and subsequent ultrasound-guided complete curettage of uterine cavity...
July 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28757766/clear-cell-carcinoma-arising-from-scar-endometriosis-a-case-report-and-literature-review
#11
Chun-Jui Wei, Shu-Han Huang
Scar endometriosis is uncommon and defined as the presence of ectopic endometrial glands in abdominal soft tissues after a gynecological operation. Malignant transformation has been reported but remains rare. Carcinogenesis occurs in ectopic endometrial tissue with repeated hormone stimulation during the menstrual cycle. We present a case of clear cell carcinoma directly arising from scar endometriosis after a cesarean section and review all 16 cases reported.
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28755018/outcomes-of-nonsurgical-versus-surgical-treatment-of-cesarean-scar-pregnancies-in-the-first-trimester
#12
Erin E Washburn, Katherine Pocius, Daniela Carusi
PURPOSE: To compare outcomes of nonsurgical versus surgical treatment of Cesarean scar pregnancies (CSP) in the first trimester and identify optimal treatment methods for CSP. METHODS: Retrospective cohort study of all women diagnosed and treated with CSP in the first trimester at a single tertiary care center from 2000-2012. Main outcome measures were need for additional treatments, hemorrhage, or emergent hysterectomy. Future pregnancy outcomes were considered secondarily...
July 28, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28753544/effect-of-female-genital-cutting-performed-by-health-care-professionals-on-labor-complications-in-egyptian-women-a-prospective-cohort-study
#13
Wael F Saleh, Haitham A Torky, Mohamed A Youssef, Wael S Ragab, Mohamed A Sayed Ahmed, Ashraf Eldaly
AIM: To examine the effect of the degree of female genital cutting (FGC) performed by health-care professionals on perineal scarring; delivery mode; duration of second stage of labor; incidence of perineal tears and episiotomy in a cohort of uncircumcised versus circumcised (types I and II) women. METHODS: A prospective cohort study included 450 primigravida women in active labor attending the Faculty of Medicine Cairo University Hospital between January 2013 and August 2014...
July 28, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28746234/outcome-of-high-intensity-focused-ultrasound-and-uterine-artery-embolization-in-the-treatment-and-management-of-cesarean-scar-pregnancy-a-retrospective-study
#14
COMPARATIVE STUDY
Yufeng Hong, Quanwei Guo, Yingjie Pu, Dongmei Lu, Min Hu
The aim of the study was to compare the efficacy and safety between high-intensity focused ultrasound (HIFU) treatment and uterine artery embolization (UAE) treatment; we retrospectively analyzed 152 cases with cesarean scar pregnancy (CSP). Based on our inclusion and exclusion criteria, 152 patients (average age, 31.8 ± 4.6 years old) with CSP were eligible for the HIFU group (85 patients) or the UAE group (77 patients). All patients in 2 groups received the treatment with suction curettage under hysteroscopy prior to HIFU or UAE treatment and followed up for 12 months...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28744163/cesarean-section-after-abdominal-mesh-repair-for-pregnancy-related-desmoid-tumor-a-case-report
#15
Sara Ooi, Harry Ngo
We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT) arising from the previous cesarean section (CS) scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28742592/pregnancy-in-an-abnormal-location
#16
Ana Monteagudo, Julie A Romero, Ilan E Timor-Tritsch
Cesarean scar pregnancy and cervical pregnancy are 2 relatively rare types of abnormally implanted pregnancies. Both if unrecognized can result in significant morbidity to the patient. The most important issue regarding cesarean scar pregnancy and cervical pregnancy is to establish the diagnosis early in order for the patient to be adequately counseled and appropriate management carried out. For both of these conditions early detection and treatment can result in preservation of fertility.
September 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28738745/is-ultrasound-guided-suction-curettage-a-reliable-option-for-treatment-of-cesarean-scar-pregnancy-a-cross-sectional-retrospective-study
#17
Hüseyin Çağlayan Özcan, Mete Gurol Uğur, Özcan Balat, Seyhun Sucu, Aynur Mustafa, Neslihan Bayramoğlu Tepe, Berna Kaya Uğur
PURPOSE: The purpose of our study is to present clinical courses and outcomes of 50 first-trimester cesarean scar pregnancy (CSP) cases, which are managed either with transabdominal ultrasound (TAUS)-guided suction curettage alone or abdominal hysterotomy. METHODS: We retrospectively analyzed our records from 2011 to 2016 at a single-center. TAUS-guided suction curettage alone was preferred in hemodynamically stable patients when the myometrial thickness was ≥ 3 mm and there was no vascular invasion...
July 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28734972/non-tubal-ectopic-pregnancies-an-overview-and-treatment-via-local-injection
#18
REVIEW
A V Dolinko, R A Vrees, G N Frishman
Ectopic pregnancies account for 1.5-2% of all pregnancy in the United States. Of these, approximately 10 percent implant in non-tubal locations, including the abdominal cavity, cervix, ovary, interstitial portion of the fallopian tube, broad ligament, the uterine cornua, or within a cesarean section scar. Because these pregnancies tend to present later than typical tubal pregnancies, they have been associated with greater maternal morbidity and mortality. Advances in ultrasound technology have allowed for earlier diagnosis of non-tubal ectopic pregnancies, which in turn has led to the development of novel minimally invasive techniques to manage them...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28721061/clinical-and-ultrasound-parameters-in-prediction-of-excessive-hemorrhage-during-management-of-cesarean-scar-pregnancy
#19
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
#20
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
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