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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2014, Number 08

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Ginecol Obstet Mex 2014; 82 (08)

Cesarean scar defect

Melo-Cerda I
Full text How to cite this article

Language: Spanish
References: 10
Page: 530-534
PDF size: 371.47 Kb.


Key words:

Cesarean scar defect, hysterorrhaphy dehiscence, isthmocele, cesarean scar, cesarean morbility.

ABSTRACT

Background: Caesarean section has immediate complications and traditional, well known later, but of equal or greater importance are the risks for the next pregnancy, due to the possibility of uterine rupture, placenta accreta, placenta previa, pregnancy or cervical scar hysterorrhaphy, and other complications not well dessiminated or known defects associated with scar hysterorrhaphy (dehiscence).
Objective: Show off frequency and caracteristics of the cesarean scar defects.
Material and method: Retrospective and observational study, by reviewing videos of patients subjected to exploration of the endocervical canal and uterine cavity whith hysteroscope in a 5 year period, in patients with a history of previous cesarean section, evaluating the integrity of the scar. The defects were classified into three categories according to the depth of the defect.
Results: patients with previous c-section, 62.5% had a defect of the closure of the scar. The total dehiscence of the muscular layer was found in patients with 1, 2 and 3 or more c-section, and only 3 cases (12%) of the defects were found at the level of the isthmus.
Conclusion: Cesarean scar defects are more frequent than we assumed. Since they favour obstetric and gynecological obstetric pathology, with the increase in the number of patients who undergo caesarean section, this has become a health problem, and we must know and promote its relationship with abnormal uterine bleeding and secondary sterility.


REFERENCES

  1. Suárez L, y col. Evidencias para la política pública en salud. Encuesta Nacional de Salud y Nutricion 2012. Instituto Nacional de Salud Pública. Disponible en http://ensanut.insp.mx.

  2. WHO. Appropate technology for birth. Lancet 1985;2:487-488.

  3. Aller J, y col. Cesárea, histerectomía obstétrica e histerorrafia. Obstetricia Moderna Capítulo 45, 3a ed. Mc Graw Hill.

  4. Osser VO, et al. Risk factors for incomplet healing of the uterine incisión after caesarean section. BJOG 2010;117:1119-1126.

  5. Melo I. Endocolposcopia histeroscopica. Revista de enfermedades del tracto genital inferior 2010;4:27-28.

  6. Roberge S, Boutin A. Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterin scar defect. Am J Perinatol 2012;29:465-471.

  7. Bujold E, et al. Prediction of complete uterine rupture by sonographic evaluation of the lower uterine segment. Am j Obstet Gynecol 2009;201:320.

  8. Morlando M, Sarno L, et al. Placenta acreta: incidence anf risk factors in an area with a particularly high rate of cesarean section. Acta Obstet Gynecol Scand 2013;92:457-460.

  9. Wang CB, Chiu WW. Cesarean scar defect: correlation between cesarean section number, defect size, clinical sintoms and uterine position. Ultrasound Obstet Gynecol 2009;34:85-89.

  10. Gubbini G, Cantini G, et al. Surgical hysteroscopic tretament of cesarean-induced isthmocele in restoring fertility: Prospective study. J of Minimally Invasive Gynecology 2011;18.




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Ginecol Obstet Mex. 2014;82