Fetal bradycardia lasting >10 min after ECV was a risk factor for asphyxia. Thus, delivery should be completed within 10 min after bradycardia. A low maternal BMI and a prolonged ECV procedure were risk factors for bradycardia after ECV.

Aim: To present the feasibility, safety and outcomes of fetoscopic endoluminal tracheal occlusion (FETO) for the treatment of severe congenital diaphragmatic hernia (CDH). Methods: This was a single-arm clinical trial of FETO for isolated left-sided CDH with liver herniation and Kitano Grade 3 stomach position (>50% stomach herniation into the right chest). FETO was performed at 27-29 weeks of gestation for cases with observed/expected lung to head ratio (o/e LHR) <25% and at 30-31 weeks for cases with o/e LHR ≥25%. Results: Eleven cases were enrolled between March 2014 and March 2016, and balloon insertion was successful in all cases. The median o/e LHR at entry was 27% (range, 20-33%). The median gestational age at FETO was 30.9 (range, 27.1-31.7) weeks. There were no severe maternal adverse events. One fetus died unexpectedly at 33 weeks of gestation due to cord strangulation by the detached amniotic membrane. There were 3 cases (27%) of preterm premature rupture of membranes. In all 10 cases, balloon removal at 34-35 weeks of gestation was successful. The median gestational age at delivery was 36.5 (range, 34.2-38.3) weeks. The median duration of occlusion and the median interval between balloon insertion and delivery were 26 days (range: 17-49 days) and 43 days (range, 21-66 days), respectively. Both the survival rate at 90 days of age and the rate of survival to discharge were 45% (5/11). Conclusion: The FETO is feasible without maternal morbidity in Japan and could be offered to women whose fetuses show severe isolated left-sided CDH to accelerate fetal lung growth.

A larger LTR after TAS was significantly associated with a better prognosis in hydropic primary FHT. The fetal lung size after the procedure may be a prognostic factor of primary FHT.

Cesarean scar syndrome (CSS) is caused by a defect in a prior cesarean section scar. Patients with CSS have gynecologic symptoms such as post-menstrual brown discharge, pelvic pain, and secondary infertility. We report three cases of CSS that received successful surgical treatment. Two cases showed post-menstrual brown discharge and one case showed a history of secondary infertility for four years. Transvaginal ultrasonography and magnetic resonance imaging indicated the cesarean scar defect and blood pooling. In all cases, we performed surgical treatment. We could not identify the cesarean scar defect by laparoscopy only. In two cases, we performed combined hysteroscopic and laparoscopic study, and in one case, we cut the myometrium vertically to identify the defect. Immediately after surgery, the post-menstrual brown discharge disappeared, and the case with secondary infertility achieved pregnancy six months after surgery. In conclusion, using hysteroscope or cutting the myometrium vertically was useful for identifying the defect.

Background Parasitic myoma is an extrauterine leiomyoma that develops because of feeding of nutrients by vessels from organs other than those of the uterus. Recently, laparoscopic myomectomy has become popular. However, incidences of iatrogenic parasitic myoma have also been reported. In this case, uterine myoma recurred after laparoscopic myomectomy and disseminated lesions were found in the peritoneal cavity with suspected uterine sarcoma.