Difficulties in Adaptation of the Mother and Newborn via Cesarean Section versus Natural Birth—A Narrative Review

Life, Год журнала: 2023, Номер 13(2), С. 300 - 300

Опубликована: Янв. 21, 2023

Birth is a physiological act that part of the morpho-functional economy maternal body. Each stage in birth has predetermined pathway neurohormonally induced and morpho-functionally established through specific characteristic adaptations. Like maternity, childbirth also an important impact on body as biological structure psycho-emotional behavior. Cesarean section performed at request mother with no medical underlying conditions besides prolonged hospitalization risk can cause breathing problems children, delayed breastfeeding, possible complications future pregnancy. Vaginal remains path choice for evolution Although erroneously considered safe easy today, cesarean delivery must remain emergency procedure or recommended pregnancies where to child, itself factor negative outcomes both baby. This review summarizes natural have newborn their attempt adapt postpartum events extrauterine life.

Язык: Английский

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Prevalence, definition, and etiology of cesarean scar defect and treatment of cesarean scar disorder: A narrative review

Reproductive Medicine and Biology, Год журнала: 2023, Номер 22(1)

Опубликована: Янв. 1, 2023

Cesarean scar defects (CSD) are caused by cesarean sections and cause various symptoms. Although there has been no previous consensus on the name of this condition for a long time, it named disorder (CSDi).

Язык: Английский

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Caesarean Scar Endometrial Defects Contribute to Post‐Caesarean Abnormal Uterine Bleeding and Chronic Endometritis: A Retrospective Case–Control Study

BJOG An International Journal of Obstetrics & Gynaecology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 7, 2025

ABSTRACT Objective To explore the role of endometrial defects in pathogenesis abnormal uterine bleeding (AUB). Design Retrospective case–control study. Setting Two tertiary centres. Population or Sample We included 155 patients with caesarean scar (CSDs) who underwent hysteroscopy (69 AUB, 86 non‐AUB). Thirty AUB were successfully matched 30 without after propensity score matching (PSM) based on CSD size and number previous sections, which indicate myometrial defect severity. Methods Hysteroscopic features before PSM compared between two groups. Pathological 13 each group biopsies surface endometrium compared, including thickness determined by haematoxylin–eosin staining, vascular density identified CD31 staining chronic endometritis assessed plasma cells stained CD138. Main Outcome Measures Incidence hysteroscopic pathological CSD. Results Before PSM, exhibited larger diverticulum sizes more severe than non‐AUB group. After five demonstrated statistically significant differences: situ haemorrhage, bloody mucus, epithelial deficiency, exposed blood vessels hyperplastic vessels. assessments also revealed differences CSD, local vascularization cell count at Conclusions Endometrial scars contribute to defects.

Язык: Английский

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Isthmocele, not cesarean section per se, reduces in vitro fertilization success: a systematic review and meta-analysis of over 10,000 embryo transfer cycles

Fertility and Sterility, Год журнала: 2023, Номер 121(2), С. 299 - 313

Опубликована: Ноя. 10, 2023

ImportancePrevious reviews have shown that a history of cesarean section (CS) is associated with worse in vitro fertilization (IVF) prognosis. To date, whether the decline IVF chances success should be attributed to CS procedure itself or presence isthmocele remains clarified.ObjectiveTo summarize available evidence regarding impact on outcomes.Data SourcesElectronic databases and clinical registers were searched until May 30, 2023.Study Selection SynthesisObservational studies included if they assessed effect outcomes. Comparators women without previous vaginal delivery. Study quality was using modified Newcastle-Ottawa Scale.Main OutcomesThe primary outcome live birth rate (LBR). The measures expressed as adjusted odds ratios (aORs) unadjusted (uORs) 95% confidence intervals (95% CIs). body Grading Recommendations Assessment, Development Evaluation working group methodology.ResultsEight (n = 10,873 patients) analysis. Women showed lower LBR than both (aOR, 0.62; CI, 0.53–0.72) those delivery 0.55; 0.42–0.71). LBRs similar 0.74; 0.47–1.15). Subgroup analysis suggested negative intracavitary fluid (ICF) (uOR, 0.36; 0.18–0.75), whereas ICF 0.94; 0.61–1.45).Conclusion RelevanceWe found moderate (Grading grade 3/4) supporting isthmocele, but not per se, undergoing IVF. adverse outcomes appears worsened by accumulation before embryo transfer.Clinical Trial Registration NumberCRD42023418266. Previous clarified. Electronic 2023. Observational Scale. methodology. Eight 0.61–1.45). We transfer.

Язык: Английский

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Reproductive factors and subsequent pregnancy outcomes in patients with prior pregnancy loss

BMC Pregnancy and Childbirth, Год журнала: 2024, Номер 24(1)

Опубликована: Март 25, 2024

Abstract Background At present, individualized interventions can be given to patients with a clear etiology of pregnancy loss improve the subsequent outcomes, but current reproductive status patient cannot changed. The aim this study was investigate association between female and subsequence outcome in prior (PL). Methods A prospective, dynamic population cohort carried out at Second Hospital Lanzhou University. From September 2019 February 2022, total 1955 women least one previous PL were enrolled. Maternal outcomes recorded through an electronic medical record system follow-up. Logistic regression used evaluate risk outcomes. Results Among all patients, rates infertility, early PL, late live birth 20.82%, 24.33%, 1.69% 50.77% respectively. In logistic regression, we found that age (OR 1.08, 95% CI 1.04–1.13) cesarean delivery history 2.46, 1.27–4.76) factors for infertility PL. Age 1.06, 1.03–1.10), first BMI 1.02–1.11), numbers 1.18, 1.04–1.57) without pre-pregnancy intervention 1.77, 1.35–2.24) non-live birth. 1.03–1.09), 1.02–1.09), 1.07, 1.15, 1.02–1.31) 2.16, 1.65–2.84) Conclusions people is strongly correlated pregnancies. Active outcome. Trial registration This registered Chinese Clinical Registry number ChiCTR2000039414 (27/10/2020).

Язык: Английский

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The alteration of uterine microbiota participated in the activation of the decidual inflammatory response in early spontaneous abortion

PLoS ONE, Год журнала: 2025, Номер 20(2), С. e0317595 - e0317595

Опубликована: Фев. 24, 2025

Background Early spontaneous abortion (ESA) is one of the most common clinically recognized pregnancy complications. While multiple factors such as embryo abnormalities and maternal conditions may contribute to ESA, early identification screening risk are increasingly important explore potential etiologies improve prevention treatment strategies for ESA. This study investigates changes in uterine microbiota decidual immune response ESA patients without abnormalities. Methods abnormality artificial (AA) controls were enrolled clinical characteristics analysis. The endometrium was subsequently collected histological evaluation inflammatory indicator detection. Moreover, 16S rRNA gene sequencing secretions performed investigate differences microorganisms between AA groups. Results Clinical analysis showed higher with elevated neutrophil counts patients. increase leukocytes, including neutrophils, positively correlated presented significantly increased IL-1β expression stromal cells. revealed greater diversity group, which decreased Lactobacillus abundance other bacteria at genus species levels. Conclusions Changes microbiome likely related lead loss.

Язык: Английский

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Isthmocele—fix it or observe, an ongoing dilemma

Fertility and Sterility, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Язык: Английский

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High live birth rates after laparoscopic isthmocele repair in infertility: a systematic review and meta-analysis

Frontiers in Endocrinology, Год журнала: 2025, Номер 16

Опубликована: Апрель 15, 2025

Background Cesarean sections are becoming more common worldwide. One of the long-term complications cesarean section is a scar defect or isthmocele. The presence isthmocele associated with infertility. Objectives This systematic review and meta-analysis examined effect laparoscopic repair on reproductive outcomes patients without Search strategy We searched MEDLINE, EMBASE, Cochrane CENTRAL databases in April 2024. Selection criteria study included cohort studies, case-control case series reporting after among women diagnosed Data collection analysis rates live birth, pregnancy, miscarriage. Main results search identified 866 records 17 articles were included. Clinical pregnancy resection 62% (95% confidence interval (CI) 54-69%) infertility, compared to 33% CI: 16-57%) infertility 36% unknown fertility status (36%, 95% 21–55%). Live birth 72% 54–85%) those 78% 46–94%) 61% 42–77%) status. Women had low miscarriage 10% 6–16%) 7% 3–18%), respectively. prevalence co-existing endometriosis was 29% 22–37%). statistical heterogeneity studies ranged from 0 86%. Conclusions Laparoscopic has demonstrated potential improve outcomes, specifically cases where linked isthmocele-related factors, such as challenges during embryo transfer impaired implantation. However, further well-designed multicenter trials must confirm these findings provide stronger evidence. Systematic registration https://www.crd.york.ac.uk/prospero/ , identifier (CRD42024548864).

Язык: Английский

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Influence of Cesarean Section on Postpartum Fertility and Dysmenorrhea: A Retrospective Cohort Study in Japan

Women s Health Reports, Год журнала: 2024, Номер 5(1), С. 22 - 29

Опубликована: Янв. 1, 2024

Objective: To investigate the association between cesarean section (CS) and postpartum fertility dysmenorrhea using data from a Japanese insurance registry. Methods: This retrospective cohort study used set of patients registered 2007 2021 in an registry comprising specific employee-based health companies Japan. Of those sets, we included participants who had their first recorded childbirth 2014 2018. The exclusion criteria were any prior deliveries, dysmenorrhea, or complications that would affect next pregnancy since 2007. occurrence subsequent until was compared CS vaginal delivery (VD) groups log-rank test Cox proportional hazards model with stratification according to age matching. Results: 25,984 (5,926 after matching) 5,926 VD groups, respectively. After matching, rate 18.3% 16.3%, 6.5% 7.8% There fewer childbirths group than matching stratified (hazard ratio [HR] 95% confidence interval [CI]: 0.86 [0.79–0.94]). significantly higher risk (HR [95% CI]: 1.18 [1.03–1.36]). Conclusions: Although confounding might be existing, our suggests associated decreased increased dysmenorrhea. medical indications for should carefully determined; post-CS women meticulously followed up.

Язык: Английский

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The impact of caesarean scar niche on fertility - a systematic review

Journal of Obstetrics and Gynaecology, Год журнала: 2024, Номер 44(1)

Опубликована: Май 22, 2024

Background The trend of increasing caesarean section (CS) rates brings up questions related to subfertility. Research regarding the influence CS on assisted reproduction techniques (ART) is conflicting. A potential mechanism behind CS-induced subfertility intra uterine fluid resulting from a scar defect or niche. vaginal microbiome has been repeatedly connected negative ART outcomes, but it unknown if changed in relation

Язык: Английский

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