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Archives of Gynecology and Obstetrics

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01-03-2017 | General Gynecology

Defect width: the prognostic index for vaginal repair of cesarean section diverticula

Authors: Xingchen Zhou, Min Yao, Jieru Zhou, Weilin Tan, Husheng Wang, Xipeng Wang

Published in: Archives of Gynecology and Obstetrics | Issue 3/2017

Abstract

Purpose

To evaluate the clinical parameter associated with cesarean section diverticula anatomic healing via vaginal repair management.

Methods

Observational cohort study. From Jul 2014 to Dec 2015, 143 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital, and 137(95.80%) were diagnosed using both transvaginal ultrasound and MRI. A total of 124 patients (86.71%) who were followed-up for more than 6 months after surgery were enrolled in this study. Excision and suture of CSD was performed through the vaginal approach. The defect sizes of the width, length, depth and TRM before or after repair were evaluated.

Results

The mean preoperative duration of menstruation was 14.47 ± 3.30 days and the thickness of the remaining muscular layer was 2.65 ± 1.13 mm before surgery. The study revealed that the healing effects of CSD repair stabilized 3 months after surgery. At the median follow-up time (11.28 months), CSD disappeared after surgery in 64.52% of patients (80/124), and 60.0% of patients (48/80) reached ≤7 days of menstruation. Meanwhile, for 35.48% of patients (44/124), CSD persisted at the median follow-up after surgery, and 31.82% (14/44) of these patients reached ≤7 days of menstruation(P < 0.05). TRM at a median follow-up time after vaginal repair >7.88 mm, 92.11% (70/76) of CSD disappeared. Moreover, when preoperative CSD width ≤18.85 mm indicates that only 18.75% (12/64) of patients will present with CSD after vaginal repair, as determined by MRI (95% CI 0.515–0.737).

Conclusion

The defect width of the preoperative CSD was the prognostic index of CSD anatomical repair effect. When the preoperative CSD width >18.85 mm, we should pay more attention to the edge of the defect during vaginal repairing.

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Title: Defect width: the prognostic index for vaginal repair of cesarean section diverticula
Authors: Xingchen Zhou
Min Yao
Jieru Zhou
Weilin Tan
Husheng Wang
Xipeng Wang
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 3/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-016-4245-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Defect width: the prognostic index for vaginal repair of cesarean section diverticula

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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