Hysteroscopic and laparoscopic management of uterine defects on previous cesarean delivery scars
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Changdong Li
Abstract
Objective: To examine the treatment of previous cesarean delivery scar defect after cesarean delivery and the feasibility of laparoscopic uterine repair or hysteroscopic scar excision.
Study Design: A retrospective clinical study that took place from June 2009 to March 2013 and included 41 women who had previously had cesarean deliveries.
Results: Seventeen women underwent a laparoscopic approach for the repair of scar diverticula, and 24 women underwent a hysteroscopic resection of fibrotic tissue overhanging underneath the diverticula. Most women remained free of symptoms over a 3- to 16-month follow-up and 6 women became pregnant without pregnancy complications.
Conclusion: Women with a history of cesarean delivery combined with irregular perimenstrual bleeding should undergo combined hysteroscopy and ultrasound examination to detect latent scar defects. In diagnosed cases, in those who desired future pregnancies and had a residual myometrial thickness of <3.5 mm or a defect that accounted for ≥50% of the anterior uterine wall, laparoscopic surgical repair was performed with good postoperative anatomic outcomes. Women with residual myometrial thickness of ≥3.5 mm or a defect that accounted for <50% of the anterior uterine wall were treated with hysteroscopic surgery and had a relief of symptoms.
Acknowledgments
This study was supported by the grants “High-Level Talents Project” (2013-3-029) and “Hundred Levels of Health Talents” from Beijing Municipal Health Bureau to Changdong Li. This study was also supported by a capital citizens health project (cultivation) from Beijing Municipal Science and Technology Commission to Changdong Li.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2014 by Walter de Gruyter Berlin Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Academy’s Corner – a new section at JPM
- Academy’s Corner
- Global education in perinatal medicine: will the bureaucracy or smartocracy prevail?
- Review articles
- Placental chorioangioma: literature review
- Sonographic measurement of cervical length as a predictor of preterm delivery: a systematic review
- Original articles – Obstetrics
- Peripartum anesthetic management of patients with Factor XI deficiency
- Risk of inferior vena cava compression syndrome during fetal MRI in the supine position – a retrospective analysis
- Fetal behavioral states are stable over daytime – evidence by longitudinal and cross-sectional fetal biomagnetic recordings
- Diet or medically treated gestational diabetes: is there any difference for obstetrical and neonatal complications? A French cohort study
- Cerebroplacental Doppler ratio and placental histopathological features in pregnancies complicated by fetal growth restriction
- Placental syndecan-1 and sulphated glycosaminoglycans are decreased in preeclampsia
- Pharmacological anti-thrombotic prophylaxis after elective caesarean delivery in thrombophilia unscreened women: should maternal age have a role in decision making?
- Values of T/QRS ratios measured during normal and post-term pregnancies
- The factors associated with the failure of transcatheter pelvic arterial embolization for intractable postpartum hemorrhage
- Hysteroscopic and laparoscopic management of uterine defects on previous cesarean delivery scars
- Chemerin concentrations in maternal and fetal compartments: implications for metabolic adaptations to normal human pregnancy
- Repetitive administration of acetylcholine receptor agonist rescues brain inflammation and brain damage after hypoxia-ischemia in newborn rat
- Original article – Fetus
- Fetal hydronephrosis: natural history and risk factors for postnatal surgery
- Original article – Newborn
- Cytomegalovirus infection among infants in California neonatal intensive care units, 2005–2010
- Letter to the Editors
- Origin of the long-term variability and acceleration of FHR studied for the prevention of cerebral palsy in fetal hypoxia and general insults
- Neonatal phototherapy, fluids, and photorelaxation
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- Academy’s Corner – a new section at JPM
- Academy’s Corner
- Global education in perinatal medicine: will the bureaucracy or smartocracy prevail?
- Review articles
- Placental chorioangioma: literature review
- Sonographic measurement of cervical length as a predictor of preterm delivery: a systematic review
- Original articles – Obstetrics
- Peripartum anesthetic management of patients with Factor XI deficiency
- Risk of inferior vena cava compression syndrome during fetal MRI in the supine position – a retrospective analysis
- Fetal behavioral states are stable over daytime – evidence by longitudinal and cross-sectional fetal biomagnetic recordings
- Diet or medically treated gestational diabetes: is there any difference for obstetrical and neonatal complications? A French cohort study
- Cerebroplacental Doppler ratio and placental histopathological features in pregnancies complicated by fetal growth restriction
- Placental syndecan-1 and sulphated glycosaminoglycans are decreased in preeclampsia
- Pharmacological anti-thrombotic prophylaxis after elective caesarean delivery in thrombophilia unscreened women: should maternal age have a role in decision making?
- Values of T/QRS ratios measured during normal and post-term pregnancies
- The factors associated with the failure of transcatheter pelvic arterial embolization for intractable postpartum hemorrhage
- Hysteroscopic and laparoscopic management of uterine defects on previous cesarean delivery scars
- Chemerin concentrations in maternal and fetal compartments: implications for metabolic adaptations to normal human pregnancy
- Repetitive administration of acetylcholine receptor agonist rescues brain inflammation and brain damage after hypoxia-ischemia in newborn rat
- Original article – Fetus
- Fetal hydronephrosis: natural history and risk factors for postnatal surgery
- Original article – Newborn
- Cytomegalovirus infection among infants in California neonatal intensive care units, 2005–2010
- Letter to the Editors
- Origin of the long-term variability and acceleration of FHR studied for the prevention of cerebral palsy in fetal hypoxia and general insults
- Neonatal phototherapy, fluids, and photorelaxation
- Congress Calendar
- Congress Calendar
