Methods for myometrium closure and other factors impacting effects on cesarean section scars of the uterine segment detected by the ultrasonography

Hayakawa, Hiromi; Itakura, Atsuo; Mitsui, Takashi; Okada, Mayumi; Suzuki, Masaki; Koji, Takehiko; Kikkawa, Fumitaka

doi:10.1080/00016340500430436

Cited by 124 publications

(108 citation statements)

References 18 publications

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“…Factors affecting cesarean scar formation were pressed in previous studies including anterior wall thickness, endometrial thickness, the degree of cervical dilatation, duration of birth pain and uterine closure technique. Additionally, our study also found the negative effect of diminished uterine arterial blood flow on uterine scar healing [21,22,23]. …”

Section: Discussionmentioning

confidence: 87%

Incomplete Healing of the Uterine Incision after Cesarean Section: Is It Preventable by Intraoperative Digital Dilatation of the Internal Cervical Ostium?

Yazicioglu

Şevket²,

Ekin³

et al. 2012

Gynecol Obstet Invest

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Background/Aims: It was the aim of this study to determine if intraoperative digital dilatation of the closed internal cervical ostium affects the healing of the uterine scar after a cesarean section (CS). Methods: In this randomized, prospective study, 94 term pregnant patients who elected to have a CS were assigned to two groups: intraoperative digital dilatation of the internal cervical ostium (group I, n = 48) or no dilatation (group II, n = 46). Vaginal ultrasound was used to check the integrity of the cesarean scar at the uterine incision site 40–42 days after the operation. We calculated the healing ratio based on ultrasonographic results and compared the groups as to the amount of incomplete healing. Results: The frequency of abnormal scarring was significantly higher in group II (14.3 vs. 40.6%; p < 0.05). The mean healing ratio was significantly higher in group I (0.95 ± 0.12) than in group II (0.87 ± 0.1; p < 0.05). In the multiple logistic regression model, digital dilatation remained the most significant factor affecting abnormal scar formation (odds ratio = 7.7). Conclusion: Digital dilatation of a closed cervix in elective CS might lower the incidence of abnormal scarring of the uterine incision.

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Section: Discussionmentioning

confidence: 87%

Incomplete Healing of the Uterine Incision after Cesarean Section: Is It Preventable by Intraoperative Digital Dilatation of the Internal Cervical Ostium?

Yazicioglu

Şevket²,

Ekin³

et al. 2012

Gynecol Obstet Invest

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“…In another prospective cohort study, when the group in which the myometrium was double-ply sutured and were compared the single-ply sutured group, less isthmocele was seen in the double-sutured group [7].…”

Section: Discussionmentioning

confidence: 99%

A New Problem Arising After the Cesarean, Cesarean Scar Defect (Isthmocele) a Case Report

Nazık¹,

Nazik²

2017

OGIJ

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Background: Cesarean rates continue to increase all over the world. This has led to a particularly rapid increase in placenta-induced complications. A definition has emerged which is now called the new name istmosel, also called cesarean scar defect. Globally, the frequency is between 6.2% and 36%. Scar tissue in the old cesarean section causes problems such as menometrorrhagia, staining and infertility in patients. There are laparoscopic and hysteroscopic treatment approaches. Since there is a new terminology, there is no comprehensive publication in the literature to provide a general view on diagnosis and treatment. The primary treatment approach we offer in this case is laparoscopic surgery.Case Presentaion: A 37-year-old patient with gravida 2, parity 2, two previous cesarean section stories had complaints of continuing intermenstrual bleeding for 2 years. When the patient's examination and radiological evaluation is done, there was fluid accumulation in the old cesarean section.In the ultrasonographic examination; a dome-shaped fluid collection of about 2.3x1.4 cm was observed in the uterine lower segment anterior Wall. As a result, laparoscopic approach was decided for istmosel treatment. Conclusion:There is no consensus in the literature as to what type of suture or energy modality should be used to repair the isthmocele. In addition, there is no consensus on the superiority of double-layer suturing and superiority of the laparoscopic or hysteroscopic approach in cesarean scar repair.

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“…Suturing technique should be considered as a predisposing factor as well. There are two small randomized trials and one prospective trial studying the effect of the suturing technique on the prevalence of a niche using ultrasound 4-6 weeks after the CS (Hayakawa et al 2006 ;Hamar et al 2007 ;Yazicioglu et al 2006 ). There was no difference in myometrial thickness between one-layer or two-layer closure (Hamar et al 2007 ), but there were less niches identifi ed after double-layer closure compared to single layer (Hayakawa et al 2006 ) or to split-level closure without inclusion of the endometrial layer (Yazicioglu et al 2006 ).…”

Section: Predisposing Factors For Nichesmentioning

confidence: 99%

Diagnostic Methods, Risk Factors of Niches, Related Symptoms and Therapies

Huirne

BijdeVaate

Voet

et al. 2014

Minimally Invasive Gynecological Surgery

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Methods for myometrium closure and other factors impacting effects on cesarean section scars of the uterine segment detected by the ultrasonography

Abstract: The incidence of uterine scar defects 1 month after cesarean sections varies with the method applied for myometrial suture and perioperative variables. The data suggest that methods for myometrium closure as well as other factors influence the condition of myometrial healing.

Cited by 124 publications

References 18 publications

Incomplete Healing of the Uterine Incision after Cesarean Section: Is It Preventable by Intraoperative Digital Dilatation of the Internal Cervical Ostium?

Incomplete Healing of the Uterine Incision after Cesarean Section: Is It Preventable by Intraoperative Digital Dilatation of the Internal Cervical Ostium?

A New Problem Arising After the Cesarean, Cesarean Scar Defect (Isthmocele) a Case Report

Diagnostic Methods, Risk Factors of Niches, Related Symptoms and Therapies

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