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cesarean scar defects

Florin Graur, Emil Mois, Radu Elisei, Luminita Furcea, Mihaela Dragota, Toader Zaharie, Nadim Al Hajjar
Endometriosis is a disease represented by the presence of extra uterine endometrial tissue. It is a rare condition, and malignant transformation is seldom. We report a case with clear cell adenocarcinoma oncogenesis on abdominal wall scar that appeared after years of a caesarian section. After diagnosis, surgical treatment was performed twice, due to the fact that the margins were infiltrated with tumor cells, with replacement of the defect with a polypropylene mesh. The patient was cured and discharged with a favorable prognostic...
April 13, 2017: Annali Italiani di Chirurgia
Ying Pan, Mu-Biao Liu
OBJECTIVE: With the incidence of cesarean scar pregnancy (CSP) rising, the reports of serious adverse outcomes of it have increased gradually. The management of CSP remains an inadequately explored clinical field, and there is no consensus on it presently. The present study was performed to investigate the efficacy and safety of operative hysteroscopy in the diagnosis and treatment of CSP. MATERIALS AND METHODS: Forty-four patients with CSP underwent operative hysteroscopy for removal of scar ectopic pregnancy in our institution...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
Natalia Gonzalez, Togas Tulandi
A relatively new type of ectopic pregnancy is cesarean scar pregnancy (CSP). This is related to the increasing number of cesarean deliveries and to the advances in imaging. There are 2 types of CSP; CSP with progression to cervicoisthmic space or uterine cavity (type I, endogenic type) or with deep invasion of scar defect with progression towards bladder and abdominal cavity (type II, exogenic type). The endogenic type of CSP could result in a viable pregnancy; yet with a high risk of bleeding at the placental site...
March 4, 2017: Journal of Minimally Invasive Gynecology
Chantale Vachon-Marceau, Suzanne Demers, Emmanuel Bujold, Stephanie Roberge, Robert J Gauthier, Jean-Charles Pasquier, Mario Girard, Nils Chaillet, Michel Boulvain, Nicole Jastrow
BACKGROUND: Uterine rupture is a potential life-threatening complication during a trial of labor after cesarean delivery. Single-layer closure of the uterus at cesarean delivery has been associated with an increased risk of uterine rupture compared with double-layer closure. Lower uterine segment thickness measurement by ultrasound has been used to evaluate the quality of the uterine scar after cesarean delivery and is associated with the risk of uterine rupture. OBJECTIVE: To estimate the impact of previous uterine closure on lower uterine segment thickness...
March 3, 2017: American Journal of Obstetrics and Gynecology
Michal Pomorski, Tomasz Fuchs, Anna Rosner-Tenerowicz, Mariusz Zimmer
BACKGROUND: The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). METHODS: Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2)...
February 10, 2017: Journal of Clinical Ultrasound: JCU
Attilio Di Spiezio Sardo, Gabriele Saccone, Rebekah McCurdy, Emmanuel Bujold, Giuseppe Bifulco, Vincenzo Berghella
OBJECTIVE: A growing body of evidence suggests that the surgical technique for uterine closure influences uterine scar healing, but there is still no consensus about optimal uterine closure during cesarean delivery (CD). The aim of this systematic review and meta-analysis was to compare the effect of single- versus double-layer closure on the risk of uterine scar defect. METHODS: MEDLINE, Scopus,, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE and the Cochrane Central Register of Controlled Trials were searched from inception of each database until May 2016...
January 10, 2017: Ultrasound in Obstetrics & Gynecology
E Dosedla, A Grendelova, P Calda
OBJECTIVES: The aim of our study was to monitor changes in the healing of Caesarean section scars in patients using systemic enzymotherapy in comparison with patients not treated with systemic enzymotherapy (Wobenzym). METHODS: A prospective cohort study was conducted in 60 primiparous women delivered by CS. We compared the following outcomes: scar thickness after the Caesarean section, dehiscence risk coefficient (DRC), severity of the Caesarean section scar defect, uterine cavity dilation, post-operative pain, C-reactive protein level and febrility...
2016: Ceská Gynekologie
Camran Nezhat, Rebecca Falik, Anjie Li
No abstract text is available yet for this article.
January 2017: Fertility and Sterility
Olivier Donnez, Jacques Donnez, Renan Orellana, Marie-Madeleine Dolmans
OBJECTIVE: To evaluate gynecological and obstetrical outcomes, as well as remaining myometrial thickness, after laparoscopic repair of a cesarean scar. DESIGN: Observational study and prospective evaluation of the remaining myometrium before and after repair. SETTING: Academic department in a university hospital. PATIENT(S): A series of 38 symptomatic women with cesarean scar defects and remaining myometrial thickness of less than 3 mm, according to magnetic resonance imaging...
January 2017: Fertility and Sterility
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 cesarean scar pregnancy (CSP) and uterine defect repair. DESIGN: Video case report, with step-by-step explanation of the procedure (Canadian Task Force classification III) SETTING: 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 18, 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 45:163-167, 2017.
March 4, 2017: 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
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