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cesarean scar defects

Erik Dosedla, Pavel Calda
OBJECTIVE: The aim of the study was to compare the sonographic characteristics of the cesarean section (CS) scar 6 weeks and 6 months after operation. We tested the hypothesis that the dehiscence risk coefficient (DRC) measured 6 weeks and 6 month after CS does not change. MATERIALS AND METHODS: A prospective longitudinal study was conducted in 43 primiparous women delivered by CS. The thickness of the myometrium proximal and distal to the CS scar, and the thickness of the CS scar were measured transvaginally...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Konrad Futyma, Krzysztof Gałczyński, Katarzyna Romanek, Aleksandra Filipczak, Tomasz Rechberger
The reported number of cesarean sections in Poland is approximately 30% and is associated with increasing number of early and late complications. The myometrial discontinuity at the site of previous cesarean section is known in the literature as "isthmocoele", "niche", "pouch" or cesarean scar defect. In most cases presence of isthmocoele has no clinical significance, but in some patients it may cause abnormal uterine bleeding, dysmenorrhea, dyspareunia, pelvic pain or be associated with secondary infertility...
2016: Ginekologia Polska
P Capmas, E Giral, H Fernandez
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
E Robinson, A Yunker
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Michal Pomorski, Tomasz Fuchs, Anna Rosner-Tenerowicz, Mariusz Zimmer
OBJECTIVE: To identify factors related to the healing of a Cesarean uterine incision using the standardized ultrasonographic approach of scar assessment in the non-pregnant uterus. STUDY DESIGN: Measurements of the uterine scar were taken from 409 women with a history of at least one low transverse cesarean section (CS) with a single layer uterine closure. Residual myometrial thickness (RMT), width (W) and depth (D) of the triangular hypoechoic scar niche, D/RMT ratio and clinical characteristics were analyzed...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Andy Schmitt, Patrice Crochet, Aubert Agostini
STUDY OBJECTIVE: To describe a technique of robotic-assisted laparoscopy of residual caesarean scar pregnancy (CSP) and uterine defect repair. DESIGN: Video case report. Step-by-step explanation of the procedure (Canadian Task Force classification III) SETTING: Cesarean scar pregnancy (CSP) may be treated by different approaches including surgery and methotrexate. Successful methotrexate treatments avoid an emergency surgical treatment. In these cases a residual CSP often remains and should be removed in women who desire to conceive...
August 17, 2016: Journal of Minimally Invasive Gynecology
Xuyin Zhang, Mengyi Yang, Qing Wang, Jianliang Chen, Jingxin Ding, Keqin Hua
OBJECTIVE: To evaluate operative and nonoperative therapies for cesarean scar defects (CSDs). METHODS: A prospective study was conducted among patients who underwent treatment of CSDs at a hospital in Shanghai, China, between April 1, 2010, and December 31, 2014. Treatment included laparoscopy (group 1), vaginal surgery (group 2), hysteroscopy (group 3), combined oral contraceptives (group 4), and the levonorgestrel intrauterine system (group 5). RESULTS: Among 142 participants, 119 patients underwent surgical repair and 23 received nonsurgical (conservative) treatment...
September 2016: International Journal of Gynaecology and Obstetrics
A Baranov, K Å Salvesen, O Vikhareva
OBJECTIVE: To compare the appearance and measurement of Cesarean hysterotomy scars in non-pregnant women and in a subsequent pregnancy at 11-14 weeks. METHODS: In a prospective cohort study we included women aged 18-35 years with one previous Cesarean delivery (CD) performed at ≥37 gestational weeks. Women were examined with saline contrast sonohysterography 6-9 months after CD. A scar defect was defined as large if the scar thickness (ST) was ≤2.5 mm. Women were followed up and those who became pregnant were examined with transvaginal ultrasound at 11-14 weeks...
July 15, 2016: Ultrasound in Obstetrics & Gynecology
Togas Tulandi, Aviad Cohen
The objective of this study was to evaluate the prevalence of cesarean scar defects and its clinical manifestations in reproductive-aged women. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement using keywords of "cesarean scar defect, uterine scar defect, uterine diverticulum niche, isthmocele, pouch, or sacculation" and their combination. Thirty-two trials met the inclusion criteria. Cesarean scar defects are commonly found on ultrasound examination (24%-88%)...
September 2016: Journal of Minimally Invasive Gynecology
Andrei Rebarber, Aneesha Varrey, Doug Scherr, Nathan Fox, Robert Sassoon, Doina Ciorica, Daniel Saltzman
A 36-year-old, gravida 8, para 6, woman with six prior cesarean sections presented at 6 weeks with a cesarean scar pregnancy. Medical management was performed initially; however, subsequent three-dimensional sonographic examinations revealed trophoblastic invasion into the bladder. This led to robotic-assisted partial cystectomy, fulguration of invaded pregnancy, and repair of the uterine defect. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound, 2016.
May 24, 2016: Journal of Clinical Ultrasound: JCU
Cuilan Li, Shiyan Tang, Xingcheng Gao, Wanping Lin, Dong Han, Jinguo Zhai, Xuetang Mo, Lee Jaden Gil Yu Kang Zhou
BACKGROUND: Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum. METHODS: Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed...
2016: BioMed Research International
Lufen Gao, Zhongwei Huang, Xian Zhang, Na Zhou, Xinke Huang, Xiaoyu Wang
OBJECTIVE: To assess the reproductive outcomes following cesarean scar pregnancy (CSP) in our center and review of published literature on CSP and subsequent reproductive issues. METHODS: Over a 3-year period, 28 cases of CSPs were diagnosed in our hospital. Follow up data of 22 cases were available which included the gestational age at diagnosis of CSP, treatments employed and outcomes of previous cesarean scar pregnancy. We also had details on subsequent fertility outcomes in these women, which included intervals between the previous CSP and subsequent pregnancy, maternal and neonatal outcomes of these subsequent pregnancies and mode of delivery...
May 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Bulent Urman, Tonguc Arslan, Sertan Aksu, Cagatay Taskiran
STUDY OBJECTIVE: To demonstrate the technique of laparoscopic repair of a large cesarean scar defect (isthmocele). DESIGN: Case report (Canadian Task Force classification III). SETTING: Cesarean scar defect, also known as an isthmocele, is the result of incomplete healing of the isthmic myometrium after a low transverse uterine incision performed for cesarean section. Although mostly asymptomatic, it may cause menstrual abnormalities (typically postmenstrual spotting), chronic pelvic pain, and secondary infertility...
September 2016: Journal of Minimally Invasive Gynecology
Ying Zhang
STUDY OBJECTIVE: The study objective was to compare transvaginal intervention and laparoscopic repair for correcting the uterine defect in patients with previous cesarean scar defect (PCSD). DESIGN: Retrospective study (Canadian Task Force classification). SETTING: Previous studies have reported that transvaginal surgery and laparoscopic surgery are available treatment options for patients with PCSD. However, the two methods have not been compared before...
May 2016: Journal of Minimally Invasive Gynecology
Soo-Youn Song, Hee-Jun Yoo, Byung-Hun Kang, Young-Bok Ko, Ki-Hwan Lee, Mina Lee
Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect...
November 2015: Obstetrics & Gynecology Science
E Giral, P Capmas, J-M Levaillant, A Berman, H Fernandez
OBJECTIVES: To determine the interest of saline contrast sonohysterography in the evaluation of number, size and shape of cesarean scar defects in comparison with 3D-transvaginal ultrasound examination. METHODS: Patients who had surgical reparation of cesarean scar defect by operative hysteroscopy were included in this retrospective study. Before surgery, they all had 3D-transvaginal ultrasound examination and saline contrast sonohysterography to establish the diagnosis...
November 2015: Gynécologie, Obstétrique & Fertilité
V Fiaschetti, M Massaccesi, M Fornari, M Nezzo, V Da Ros, G Sorrenti, G Simonetti
The term "isthmocele" refers to a niche on the anterior wall of the uterine isthmus or of the cervical canal at the site of a previous cesarean delivery scar. Such anatomic defect can cause many gynecologic sequelae that only recently have being identified and described. Hysteroscopy is commonly considered the gold standard for the diagnosis and also for the treatment, at least in the case of defects of small size. The authors described the case of a 37-year-old woman who underwent a cesarean section (CS) seven years before, with a long lasting history of menstrual irregularities, and pelvic pain increasing during menstruation at the hypogastric level...
2015: Clinical and Experimental Obstetrics & Gynecology
Antonio F Saad, Maged M Costantine, George Saade, Michel Makhlouf
Introduction Uterine rupture occurs in less than 0.1% of pregnancies. This complication can be detrimental to mother and fetus if not detected and managed in a timely manner. We report an unusual presentation of uterine scar rupture that was diagnosed on ultrasound in a completely stable patient with reassuring fetal status. Case Report A 24-year-old Gravida 5, Para 3 with history of cornual resection for ectopic pregnancy and two previous uterine ruptures presented at 30 weeks' gestation with worsening abdominal pain...
October 2015: American Journal of Perinatology Reports
Murat Api, Aysen Boza, Husnu Gorgen, Olus Api
Several obstetric complications due to inappropriately healed cesarean scar such as placenta accreta, scar dehiscence, and ectopic scar pregnancy are increasingly reported along with rising cesarean rates. Furthermore, many gynecologic conditions, including abnormal uterine bleeding, pelvic pain and infertility, are imputed to deficient cesarean scar healing. Hysteroscopy is the most commonly reported approach for the revision of cesarean scar defects (CSDs). Nevertheless, existing evidence is inadequate to conclude that either hysteroscopy or laparoscopy is effective or superior to each other...
November 2015: Journal of Minimally Invasive Gynecology
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