The problem of the untenableness of the uterine scar after cesarean section DOI Open Access

A.A. Ermolenko,

С. В. Баринов

Scientific Bulletin of the Omsk State Medical University, Год журнала: 2023, Номер 3(1), С. 18 - 30

Опубликована: Янв. 1, 2023

Over the past decades, frequency of cesarean section operations in world has increased by 50%, and Russian Federation – 10 times, doctors are increasingly witnessing formation untenable scars on uterus. The appearance a scar uterus after is inevitable, since smooth muscle tissue minimal ability to proliferate regenerate damage. occurrence an ranges from 19% 86%, which explained complexity diagnosing this condition. most common clinical manifestations defect abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, infertility; as well asymptomatic period that often found. Currently, there no terminology clear criteria recommendations for assessing only generally accepted Delphi international consensus, approved European experts 2019, but it applicable ultrasound assessment scar. use sonohysterography with saline solution considered promising diagnostics. treatment indicated case symptoms woman's desire restore lost fertility. possibilities medication failure very limited insufficiently investigated. Modern research suggests performing minimally invasive resection procedure first-choice operation. active discussion about preferred method delivery women Recent studies indicate up 75% patients who have undergone surgery can successfully undergo vaginal delivery. Successful associated fewer complications than repeated birth. Nowadays, does not exceed 1,5%. An additional study causes regarding improvements therapeutic diagnostic measures required.

Язык: Английский

Bridging the Diagnostic Gap between Histopathologic and Hysteroscopic Chronic Endometritis with Deep Learning Models DOI Creative Commons
Kotaro Kitaya,

Tadahiro Yasuo,

Takeshi Yamaguchi

и другие.

Medicina, Год журнала: 2024, Номер 60(6), С. 972 - 972

Опубликована: Июнь 12, 2024

Chronic endometritis (CE) is an inflammatory pathologic condition of the uterine mucosa characterized by unusual infiltration CD138(+) endometrial stromal plasmacytes (ESPCs). CE often identified in infertile women with unexplained etiology, tubal factors, endometriosis, repeated implantation failure, and recurrent pregnancy loss. Diagnosis has traditionally relied on biopsy histopathologic/immunohistochemistrical detection ESPCs. Endometrial biopsy, however, a somewhat painful procedure for subjects does not allow us to grasp whole picture this mucosal tissue. Meanwhile, fluid hysteroscopy been recently adopted as less-invasive diagnostic modality CE. We launched ARCHIPELAGO (ARChival Hysteroscopic Image-based Prediction histopathologic chronic Endometritis using deep LeArninG mOdel) study construct hysteroscopic finding-based prediction tools The development these learning-based novel models computer-aided detection/diagnosis systems potentially benefits suffering from elusive disease.

Язык: Английский

Процитировано

2
Management strategies following implantation failure of euploid embryos DOI Creative Commons
Keiji Kuroda

Reproductive Medicine and Biology, Год журнала: 2024, Номер 23(1)

Опубликована: Янв. 1, 2024

Euploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT-A); however, various nonembryonic can also intricately interfere with implantation. This review seeks to clarify evidence-based and treatments after euploid embryo transfer.

Язык: Английский

Процитировано

1
A Trimming Technique: A Case Report of a Novel Surgical Approach for Cesarean Scar Dehiscence During Cesarean Section DOI Open Access
Daisuke Katsura, Shunichiro Tsuji,

Takako Hoshiyama

и другие.

Yonago acta medica, Год журнала: 2023, Номер 66(2), С. 287 - 291

Опубликована: Янв. 1, 2023

Cesarean section can lead to residual myometrial thickness thinning and cesarean scar syndrome. We report a novel trimming technique for recovery in women with Case 1: A 33-year-old woman who developed syndrome (CSS) abnormal uterine bleeding post-cesarean became pregnant following hysteroscopic treatment. The myometrium at previous was dehiscent; therefore, transverse incision made above the scar. Post-operative failed owing lochia retention, again. 2: 29-year-old spontaneously. dehiscent like case 1. Scar repair performed using during section; there were no subsequent complications she conceived again Performing this surgical procedure may contribute

Язык: Английский

Процитировано

3
Impact of cesarean scar defect on reproductive outcomes after assisted reproductive technology DOI
Ling Wang,

Chenhan Zhao,

Qin Zhang

и другие.

Journal of Zhejiang University (Medical Sciences), Год журнала: 2024, Номер 53(3), С. 313 - 320

Опубликована: Март 1, 2024

In the last twenty years, cesarean section rate has been rising in China, leading to an increased prevalence of scar defect (CSD) and secondary infertility. CSD decreases receptivity endometrium, induces adenomyosis endometriosis, disrupts uterine micro-environment causes difficulties embryo transplant operation as well further pregnancy complications. For women undergoing assisted reproductive technology (ART), significantly reduces live birth rate, clinical implantation rate. can be effectively treated by hysteroscopic surgery, laparoscopic surgery transvaginal increase This article reviews research progress on impact outcomes ART, potential factors related treatments, provides a reference for management patients ART.

Язык: Английский

Процитировано

0
Emerging data on diagnosis and management of uterine isthmoceles: a rapid review DOI

Elizabeth N. Cook,

Nicholas Jesse,

Lara Harvey

и другие.

Current Opinion in Obstetrics & Gynecology, Год журнала: 2024, Номер 36(4), С. 313 - 323

Опубликована: Май 23, 2024

Purpose of review With a rising number cesarean sections, the prevalence uterine isthmoceles is increasing. We performed rapid to assess most recent data on diagnosis and management over past 18 months identify current trends directions for continued research. Recent findings A comprehensive search was conducted in PubMed (NLM), Embase (Ovid), CINAHL (EBSCOhost) find English written articles discussing or published previous months. Data extraction one hundred that met inclusion criteria. Summary This highlights agreement regarding diagnostic methods, symptoms, recommended treatment paths patients with symptomatic niches. However, diversity definitions hampers capacity formulate detailed conclusions features niches their impact women's health.

Язык: Английский

Процитировано

0
Isthmocele: controversial issues of terminology, diagnosis and treatment. A review DOI Creative Commons
Н. М. Подзолкова,

Anton V. Demidov,

Vasilii В. Osadchev

и другие.

GYNECOLOGY, Год журнала: 2024, Номер 26(2), С. 119 - 127

Опубликована: Июнь 10, 2024

The frequency of abdominal delivery in the world is steadily rising. Since latter associated with a lot complications compared vaginal delivery, increase proportion deliveries women uterine scar through natural birth canal an important strategic goal obstetrics and gynecology community. In addition, it established that every second patient after cesarean section develops defect area, which often accompanied by various disorders menstrual cycle (in 25,5% cases – abnormal bleeding) can cause secondary infertility. Both assessment risk failure at stage preconceptional preparation timely detection treatment isthmocele symptoms are still serious challenges facing obstetricians gynecologists. Clinical guidelines devoted to problem have not yet been developed. This review presents quintessence modern data on possible factors, clinical manifestations detailed consideration pathophysiological mechanisms, diagnostic tools correction methods symptomatic description indications comparative their effectiveness order standardize approaches diagnosis these pathological conditions.

Язык: Английский

Процитировано

0
Advanced repair of recurrent and low-large hysterotomy defects using a myometrial glide flap DOI Creative Commons
José M. Palacios‐Jaraquemada, Nicolás Basanta, Albaro José Nieto‐Calvache

и другие.

The Journal of Maternal-Fetal & Neonatal Medicine, Год журнала: 2024, Номер 37(1)

Опубликована: Янв. 2, 2024

Background The resolution of factors linked to the recurrence cesarean section defects can be accomplished through a comprehensive technique that effectively addresses dehiscent area, eliminates associated intraluminal fibrosis, and establishes vascularized anterior wall by creating sliding myometrial flap.

Язык: Английский

Процитировано

0
The Correlation between Chronic Endometritis and Caesarean Scar Diverticulum DOI
Junchao Zhang, Jinfa Huang, Zexian Xu

и другие.

Journal of Reproductive Immunology, Год журнала: 2024, Номер 166, С. 104324 - 104324

Опубликована: Авг. 28, 2024

Язык: Английский

Процитировано

0
Exploring uterine niche: A systemic review on secondary infertility rates, pathophysiological correlations, impact on assisted reproduction technology (ART), and the efficacy of surgical interventions. DOI Creative Commons
D. M. C. S. Jayasundara, I. A. Jayawardane, TDKM Jayasingha

и другие.

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Окт. 22, 2024

Abstract Background: The rising trend of cesarean sections worldwide has resulted in an increased incidence uterine niches, a cavity formed at the scar site due to impaired tissue healing. Secondary infertility women with niches is hot topic obstetrics and gynecology. Therefore, current study aims untwist link between secondary niche, exploring pathophysiological correlations, effects on assisted reproduction technology, role surgical interventions resuming fertility. Methodology: PubMed, Cochrane Library, Embase, Science Direct were searched systematically. Rayyan was employed as semi-automated tool for selection. Full-text articles English language included. Systematic reviews, meta-analyses, or book chapters excluded. Newcastle-Ottawa Scale assessed quality cohort case-control studies, while Risk-of-bias evaluated randomized controlled trials. Data synthesis followed thematic analysis. Results: 35 from 3301 studies met inclusion criteria. Among those, 25 only one trial, rest had different designs. The assessment revealed average good quality. ranged 27.37% (n=95) 75% (n=16). Decreased residual myometrial thickness, chronic inflammatory changes niche site, fluid accumulation within identified leading causes infertility. adversely affected reproductive outcomes through multiple mechanisms. Various interventions, including hysteroscopy, laparoscopy, combined surgery, showed differing efficacies restoring Conclusion: provides valuable insights regarding association niche. However, smaller sample sizes, retrospective nature designs, reliance observational data, heterogeneity reporting have limited ability arrive solid conclusions. we encourage well-designed prospective trials, further explore this trending area. protocol prospectively registered International Prospective Register Reviews (PROSPERO CRD4204526319).

Язык: Английский

Процитировано

0
Reevaluating the variation of cesarean scar defect DOI Open Access
Hiroshi Kobayashi,

Shogo Imanaka

Journal of Obstetrics and Gynaecology Research, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 5, 2024

Abstract Aim The increasing incidence of cesarean sections has led to a higher prevalence scar defects (CSDs), predominantly characterized by postmenstrual bleeding in affected women. CSD manifests various forms, including isolated myometrial defects, intrauterine cystic protrusions, and extrauterine extensions. pathophysiological mechanisms underpinning its associated symptoms remain insufficiently understood. This review explores the pathogenesis CSD, highlights morphological characteristics with an emphasis on variable clinical diversity, addresses challenges for future research. Methods A comprehensive narrative was conducted using electronic databases, PubMed Google Scholar, identify 41 relevant literatures published up December 31, 2023. Results myometrium comprises two distinct layers—the inner outer myometrium—with differences their origin, structure, function. Disruptions within these layers contribute development. Histopathologically, symptomatic may be linked uterine endometriosis, adenomyosis, or endometrial cysts, suggesting that particularly those necessitating surgical intervention, are not limited but also involve iatrogenic endometriosis thereby exacerbating symptoms. Conclusion provides updated understanding histopathological features classification elucidating underlying pathogenesis.

Язык: Английский

Процитировано

0