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.
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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
