keyword
https://read.qxmd.com/read/37123052/cesarean-scar-pregnancy-and-successful-ultrasound-guided-removal-after-uterine-artery-ligation
#21
Vito Leanza, Giosuè Giordano Incognito, Ferdinando Antonio Gulino, Attilio Tuscano, Monia Cimino, Marco Palumbo
A correct management of cesarean scar pregnancy (CSP) is mandatory to avoid further complications. There is no consensus for the standard therapy and the most frequent methods used are not free from failures and sequelae. A 38-year-old woman was admitted referring amenorrhea lasting 9 weeks, pelvic pain, and vaginal bleeding. She had three previous cesarean sections. Transvaginal ultrasound showed a gestational sac of 16 mm in the cervico-isthmic site and inside the thickness of the uterine wall, and the dosage of beta-human chorionic gonadotropin was 12,770 mU/mL...
2023: Case Reports in Obstetrics and Gynecology
https://read.qxmd.com/read/37009324/intra-operative-diagnosis-of-lower-segment-scar-dehiscence-in-a-second-gravida-after-one-previous-lower-segment-cesarean-section-should-we-advocate-for-routine-antenatal-uterine-scar-thickness-testing
#22
George Uchenna Eleje, Gerald Okanandu Udigwe, Chigozie Geoffrey Okafor, Tobechi Kingsley Njoku, Chukwuemeka Chukwubuikem Okoro, Chukwudubem Chinagorom Onyejiaka, Emeka Philip Igbodike, Onyeka Chukwudalu Ekwebene, Ekeuda Uchenna Nwankwo, Perpetua Chinedu Okolie, Emmanuel Chukwubuikem Egwuatu, John Chukwuebuka Nkesi, Obinna Carl Okafor, Chidimma Maryvianny Okeke, Divinefavour Echezona Malachy, Ogechi Odinakachukwu Dimgba, Nwabueze Chidozie Okeke, Kenechukwu Chukwudum Okeke, Bernard Kachi Nwadili, Harrison Chiro Ugwuoroko, Casmir Chukwudi Madubuko, Lambert Chukwu Onyejiaku
BACKGROUND: Uterine dehiscence is a separation of uterine musculature with intact uterine serosa. It can be encountered at the time of cesarean delivery, suspected on obstetric ultrasound or diagnosed in-between pregnancies. The antenatal diagnosis may occasionally elude the Obstetricians. This particular case demonstrates an intra-operative diagnosis of uterine dehiscence with missed antenatal ultrasound diagnosis in an asymptomatic woman. CASE PRESENTATION: She was a 32-year-old Nigerian second gravida who booked for antenatal care at 32 weeks of gestation following a referral from her attending Obstetrician from a neighboring state due to relocation...
2023: Clinical Medicine Insights. Case Reports
https://read.qxmd.com/read/36972013/effect-of-cervical-changes-on-the-cesarean-scar-area-and-niche-formation-after-preterm-and-term-cesarean-sections
#23
JOURNAL ARTICLE
Sukran Dogru, Fatih Akkus, Aslı Altınordu Atcı, Kübra Memnune Erdoğan, Ali Acar
OBJECTIVE: The purpose of this study is to assess the scar area and niche formation after cesarean section in women who had preterm or term deliveries and underwent cesarean section at various stages of labor. METHOD: This prospective cohort study consists of cases who underwent the first cesarean section for different obstetric reasons. The patients were divided into four groups regarding gestational age and cervical dilatation. After a cesarean section, all patients were called for vaginal ultrasonography control at 12 weeks...
March 27, 2023: Journal of Ultrasound
https://read.qxmd.com/read/36868338/perinatal-assessment-of-complex-cesarean-delivery-beyond-placenta-accreta-spectrum
#24
JOURNAL ARTICLE
Eric Jauniaux, Karin A Fox, Brett Einerson, Ahmed M Hussein, Jonathan L Hecht, Robert M Silver
Multiple cesarean deliveries are known to be associated with long-term postoperative consequences because of a permanent defect of the lower uterine segment wall and the development of thick pelvic adhesions. Patients with a history of multiple cesarean deliveries often present with large cesarean scar defects and are at heightened risk in subsequent pregnancies of cesarean scar ectopic pregnancy, uterine rupture, low-lying placenta or placenta previa, and placenta previa accreta. Moreover, large cesarean scar defects will lead to progressive dehiscence of the lower uterine segment with the inability to effectively reapproximate hysterotomy edge and repair at birth...
August 2023: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/36814526/diagnostic-accuracy-of-placental-thickness-in-lower-uterine-segment-measured-by-ultrasound-in-prediction-of-placenta-accreta-spectrum-in-patients-with-placenta-previa-a-diagnostic-test-accuracy-study
#25
JOURNAL ARTICLE
Ahmed Mohammed Elmaraghy, Salah Taha Fayed, Mahmoud Abd ElHamid Ali, Monira Ali Hassanien, Ahmed Mohamed Mamdouh
OBJECTIVE: The aim of the study was to evaluate the association between placental thickness and placenta accreta spectrum (PAS) in patients with placenta previa. MATERIALS AND METHODS: In this prospective study, 40 patients diagnosed with placenta previa were included. The maximum placental thickness in the lower uterine segment was obtained using a transabdominal scan. For the image to be deemed suitable, a midline sagittal section of the lower uterine segment (with the implanted placenta) and the cervical canal, with the intervening urinary bladder had been required...
2023: International Journal of Women's Health
https://read.qxmd.com/read/36809793/the-cesarean-scar-of-pregnancy-ultrasound-findings-and-expectant-management-outcomes
#26
JOURNAL ARTICLE
Catherine Y Spong, Casey S Yule, Elaine T Fleming, Ashlyn K Lafferty, Donald D McIntire, Diane M Twickler
OBJECTIVE:  The nomenclature has evolved from low implantation to cesarean scar pregnancy (CSP) and criteria are recommended for identification and management. Management guidelines include pregnancy termination due to life-threatening complications. This article applies ultrasound (US) parameters recommended by the Society for Maternal Fetal Medicine (SMFM) in women who were expectantly managed. STUDY DESIGN:  Pregnancies were identified between March 1, 2013 and December 31, 2020...
March 31, 2023: American Journal of Perinatology
https://read.qxmd.com/read/36730180/diagnosis-and-management-of-isthmocele-cesarean-scar-defect-a-swot-analysis
#27
REVIEW
J A Dominguez, L Alonso Pacheco, E Moratalla, J A Carugno, M Carrera, F Perez-Milan, M Caballero, J L Alcázar
The purpose of this State-of-the-Art Review was to provide a strategic analysis, in terms of strengths, weaknesses, opportunities and threats (SWOT analysis), of the current evidence regarding the management of uterine isthmocele (Cesarean scar defect). Strengths include the fact that isthmocele can be diagnosed on two-dimensional transvaginal ultrasound, and that surgical repair may restore natural fertility potential and prevent secondary infertility, as well as reduce the risk of miscarriage and other obstetric complications...
September 2023: Ultrasound in Obstetrics & Gynecology
https://read.qxmd.com/read/36720259/uterine-scar-evaluation-during-the-postpartum-pleading-for-extra-decidual-suturing-during-cesarean-section
#28
JOURNAL ARTICLE
Assaad Kesrouani, Yara Abdelkhalek, Wael Abdallah, Christian Chaccour, Inaam Hatoum, F Richa
Objective To evaluate ultrasound differences in uterine scar between techniques using extra mucosal suturing and full thickness suturing of the uterine incision. Methods A retrospective observational study included cases of primary cesarean section. At six weeks postpartum, we evaluated by endovaginal ultrasound two elements in the sagittal view: the thickness of the uterine scar and the surface of defect (niche). Hysterotomy sites closed using a running full-thickness technique including the uterine mucosa (group1) were compared to hysterotomies operated by the same surgeon but with extra mucosal suturing (group 2)...
January 31, 2023: American Journal of Perinatology
https://read.qxmd.com/read/36682134/evaluation-of-ultrasound-airway-assessment-parameters-in-pregnant-patients-and-their-comparison-with-that-of-non-pregnant-women-a-prospective-cohort-study
#29
JOURNAL ARTICLE
S Y Vajanthri, S Mohammed, M Kumar, S Chhabra, P Bhatia, M Kamal, B Paliwal
BACKGROUND: Clinical airway assessment parameters differ significantly between pregnant and non-pregnant patients, however literature comparing their ultrasound (US) airway parameters is limited. We planned a prospective cohort study to compare US-assessed airway parameters between pregnant and non-pregnant women. METHODS: We enrolled 82 pregnant females scheduled for elective cesarean section under neuraxial anesthesia and 80 age-matched non-pregnant females scheduled for elective surgery...
February 2023: International Journal of Obstetric Anesthesia
https://read.qxmd.com/read/36598096/measurement-of-lower-uterine-segment-thickness-to-detect-uterine-scar-defect-comparison-of-transabdominal-and-transvaginal-ultrasound
#30
JOURNAL ARTICLE
Isobel Marchant, Lauriane Lessard, Catherine Bergeron, Nicole Jastrow, Robert Gauthier, Mario Girard, Paul Guerby, Chantale Vachon-Marceau, Sarah Maheux-Lacroix, Emmanuel Bujold
OBJECTIVES: Lower uterine segment (LUS) thickness measurement using transabdominal ultrasound (TA-US), transvaginal ultrasound (TV-US), or the combination of both methods can detect scar defect in women with prior cesarean. We aimed to compare the sensitivity of three approaches. METHODS: Women with prior cesarean underwent LUS thickness measurement at 34-38 weeks' gestation. Among those who underwent repeat cesarean before labor, we compared the accuracy of TA-US, TV-US, and the thinner of the two measurements (the "combined measurement") for uterine scar dehiscence using the area under the curve (AUC) of receiver operating curves with their 95% confidence intervals (CI)...
January 4, 2023: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://read.qxmd.com/read/36569135/spontaneous-pregnancy-after-tracking-ovulation-during-menstruation-a-case-report-of-a-woman-with-premature-ovarian-insufficiency-and-repeated-failure-of-in-vitro-fertilization
#31
Ye He, Wanlu Wang, Chunmei Wu, Wenwen Li, Hongjiang Liu, Zhaolian Wei
The diagnosis of premature ovarian insufficiency (POI) is devastating in women of reproductive age because of the small chance of spontaneous pregnancy. Here, we report a very rare case with POI and repeated failure of in vitro fertilization (IVF) where the final result was natural fertilization following guidance to have sexual intercourse during menstruation as ovulation was monitored. Estradiol valerate was used to increase the thickness of the endometrium and stop the menstrual bleeding. There was a serum level of 208...
2022: Frontiers in Medicine
https://read.qxmd.com/read/36536838/prediction-of-uterine-dehiscence-via-machine-learning-by-using-lower-uterine-segment-thickness-and-clinical-features
#32
JOURNAL ARTICLE
Mervenur Kement, Cihan Emre Kement, Mahmut Kuntay Kokanali, Melike Doganay
BACKGROUND: With the global increase of cesarean delivery rates, the long-term effects of cesarean delivery have started to become clearer. One of the most prominent complications of cesarean delivery in recurrent pregnancies is uterine rupture. Assessing the risk of uterine rupture by accurately predicting dehiscence is very important to prevent untimely operations and/or maternal and fetal complications. OBJECTIVE: This study aimed to assess whether machine learning can be used to predict uterine dehiscence by using patients' ultrasonographic findings, clinical findings, and demographic data as features...
November 2022: AJOG global reports
https://read.qxmd.com/read/36394552/intraoperative-ultrasound-during-repeat-cesarean-delivery-facilitates-sampling-of-uterine-scar-tissue
#33
JOURNAL ARTICLE
Alexander Paping, Clara Basler, Kerstin Melchior, Loreen Ehrlich, Mario Thiele, Georg N Duda, Wolfgang Henrich, Thorsten Braun
OBJECTIVES: Histological examination of uterine scars provides insight into uterine wound healing and helps to develop prevention methods of uterine wall rupture after previous uterine surgery. Therefore, exact intraoperative scar identification is needed for specimen collection from the actual scar tissue. The aim of this study was to correlate pre- and intraoperative ultrasound measurements of the lower uterine segment (LUS) with histological findings of scar tissue and to evaluate the relevance of intraoperative ultrasound...
November 18, 2022: Journal of Perinatal Medicine
https://read.qxmd.com/read/36262982/prediction-of-scar-myometrium-thickness-and-previous-cesarean-scar-defect-using-the-three-dimensional-vaginal-ultrasound
#34
JOURNAL ARTICLE
Liang Shi, Keke Du
This research aimed to explore the related factors of scar myometrial thickness and scar diverticulum formation and then predict the occurrence of uterine diverticula. 140 patients with cesarean section were selected as the research objects. According to the three-dimensional (3D) vaginal ultrasound echo and the diagnostic criteria of uterine diverticulum, the research objects were divided into a diverticulum group and a control group, with 70 cases in each group. Data such as age, number of cesarean sections, endometrial thickness, uterine position, and diverticulum size was collected, and their relationship with uterine diverticulum was compared and analyzed...
2022: Contrast Media & Molecular Imaging
https://read.qxmd.com/read/36262051/experience-in-management-of-cesarean-scar-pregnancy-and-outcomes-in-a-single-center
#35
JOURNAL ARTICLE
Dong-Fang Wu, Hong-Xia Zhang, Wen He, Xin Liu, Hai-Man Song, Teng-Fei Yu
OBJECTIVE: This study aimed to describe our experience of managing cesarean scar pregnancy (CSP) and outcomes depending on ultrasound imaging features. METHODS: A retrospective, cohort observational study was performed on 31 consecutive patients with CSP at 6 to 9 weeks of gestation from April 2015 to January 2021. All patients were evaluated for the residual myometrial thickness (RMT), growth direction of the gestational sac (GS), blood flow, and chorionic parenchyma using ultrasonography...
October 2022: Journal of International Medical Research
https://read.qxmd.com/read/36239236/preoperative-sonographic-sliding-sign-for-prediction-of-intra-abdominal-adhesions-before-repeat-cesarean-delivery
#36
JOURNAL ARTICLE
Kla Charernjiratragul, Thitima Suntharasaj, Savitree Pranpanus, Suthiraphorn Chanwadi, Noppasin Kwankaew, Chusana Petpichetchian
OBJECTIVE: To evaluate the usefulness of the uterine sliding sign for predicting intra-abdominal adhesions in women undergoing repeat cesarean section (CS) and the association of the sliding sign with other operative and neonatal outcomes. METHODS: A prospective cohort study was conducted among pregnant women with at least one previous CS. Transabdominal ultrasonography was performed and classified as a positive or negative sliding sign. Surgeons blinded to the sonographic results assessed intra-abdominal adhesions...
October 14, 2022: International Journal of Gynaecology and Obstetrics
https://read.qxmd.com/read/36122977/placenta-accreta-spectrum-prenatal-diagnosis-and-management
#37
REVIEW
Rebecca Horgan, Alfred Abuhamad
The incidence of placenta accreta spectrum (PAS) is increasing and is now about 3 per 1000 deliveries, largely due to the rising cesarean section rate. Ultrasound is the preferred method for diagnosis of PAS. Ultrasound markers include multiple vascular lacunae, loss of the hypoechoic retroplacental zone, abnormalities of the uterine serosa-bladder interface, retroplacental myometrial thickness less than 1 mm, increased placental vascularity, and observation of bridging vessels linking the placenta and bladder...
September 2022: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/36063193/morphological-differences-in-the-female-anal-sphincter-complex-between-endoanal-and-exoanal-ultrasound
#38
JOURNAL ARTICLE
Wen Lieming, Zhao Baihua, Tang Yingchun, Guo Yuyang, Xiao Xian
INTRODUCTION AND HYPOTHESIS: This study was aimed at describing the morphological characteristics of the normal female anal sphincter complex (ASC) by high-resolution transperineal ultrasound (TPUS) and endoanal ultrasound (EAUS). METHODS: Thirty volunteers, including 19 nulliparous and 11 women who had only given birth by Cesarean section, were recruited. The ASC was shown in a set of five slices by EAUS and 8 slices by TPUS. EAUS slices 1 and 5 matched TPUS slices 1 and 8; EAUS slices 2, 3, and 4 were approximately at the levels of TPUS slices 3, 5, and 7...
September 5, 2022: International Urogynecology Journal
https://read.qxmd.com/read/35929843/postoperative-morphologic-changes-of-the-isthmocele-and-clinical-impact-in-patients-treated-by-channel-like-360%C3%A2-hysteroscopic-technique
#39
JOURNAL ARTICLE
Paolo Casadio, Antonio Raffone, Andrea Alletto, Francesco Filipponi, Diego Raimondo, Alessandro Arena, Mariangela La Rosa, Agnese Virgilio, Camilla Franceschini, Giampietro Gubbini, Mario Franchini, Roberto Paradisi, Jacopo Lenzi, Antonio Travaglino, Antonio Mollo, Josè Carugno, Renato Seracchioli
OBJECTIVE: To evaluate the changes in (1) residual myometrial thickness (RMT), (2) cesarean scar defect (CSD) size, and (3) clinical symptoms, before and after channel-like (360°) hysteroscopic resection for the treatment of CSD. METHODS: A single-center, observational, prospective, cohort study was carried out enrolling all symptomatic patients of childbearing age, diagnosed with CSD and routinely scheduled for channel-like (360°) hysteroscopic resection from July 2020 to July 2021 at the Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Univeristaria di Bologna...
August 5, 2022: International Journal of Gynaecology and Obstetrics
https://read.qxmd.com/read/35907811/clinical-efficacy-and-safety-of-high-intensity-focused-ultrasound-hifu-ablation-in-treatment-of-cesarean-scar-pregnancy-csp-i-and-ii
#40
JOURNAL ARTICLE
Yanglu Liu, Qiaozhi Yin, Fan Xu, Shuang Luo
OBJECTIVE: To investigate the safety and feasibility of high intensity focused ultrasound (HIFU) ablation followed by ultrasound-guided dilation and curettage (USg-D&C) for two types patients with cesarean scar pregnancy (CSP-I and CSP-II). MATERIALS AND METHODS: This study was a retrospective analysis of 101 CSP-I patients and 52 CSP-II patients who received HIFU ablation followed by USg-D&C from Jun 2014 to Oct 2020. The diameter of gestational sac/mass, thickness of the intervening myometrium, intraoperative blood loss, operation time, length of hospital stays, adverse effects and β-HCG level in the two groups were compared...
July 30, 2022: BMC Pregnancy and Childbirth
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