Early identification of uterine scar defect by preconception magnetic resonance imaging to achieve successful pregnancy outcome after laparoscopic‐assisted myomectomy: Two case reports

Takeda, Akihiro; Shibata, Mayu; Koike, Wataru

doi:10.1002/ccr3.5441

Cited by 3 publications

(2 citation statements)

References 21 publications

(74 reference statements)

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“…The diagnostic criteria for MRI are set in the cases of invasive abnormal placentation. The diagnostic accuracy of MRI is more in determination of posterior placentation 22 .…”

Section: Discussionmentioning

confidence: 99%

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Afridi¹,

Orakzai²,

Yasmeen³

et al. 2022

PJMHS

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Abnormal placentation has raised the ratio of cesarean cases. In such obstetric complication the placenta lie at the lower segment of the uterus. These abnormal attachments of placenta to uterus and invasion to adjacent organs are the main cause of placenta previa. These are not only raising delivery challenges but also raising the mortality cases. Objective: For evaluation of the diagnostic efficacy of MRI to locate placentation abnormalities with high accuracy and sensitivity. This not only helps in preoperative delivery planning but also decreases the ratio of mortality. Study Setting: It was an observational study, conducted at radiology department of Mardan Medical Complex Mardan for the duration of six months from September 2021 to February 2022. Methods: The women suspicion of placentation abnormalities were recommended with MRI. The consecutive 185 pregnant women were included in the study. The results obtained from MRI were compared with the results obtained by C-section. Cesarean section results were considered as standard. The treatment strategy was decided in accordance with the MRI findings. The treatment strategies which opt during the CS were compared with the strategy created on the basis of MRI. Results: 115 women were diagnosed with abnormal placentation. The 70 women out of 185 were diagnosed with placenta previa. The percentage false results were seen in 18 patients. The false negative results of MRI were seen in three patients. After comparison between the findings of MRI and CS the sensitivity, positive predictive values and other parameters were calculated. The sensitivity was 97%, while the positive predictive value was 84%. The other parameters such as specificity were 79% and negative predictive value was 95%. The sensitivity, accuracy, and positive predictive values of the planning strategy created for treatment on the basis of MRI findings were calculated. There was significant correlation between the findings of MRI and CS. Conclusion: For the future planning of treatment strategy for the women suspected of abnormal placentation, MRI is highly suggested diagnostic tool with better efficacy and sensitivity. This imaging modality helps in proper and accurate diagnosis of abnormal placentation. Keywords: Abnormal placentation, obstetric complications, treatment strategy, placenta previa.

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“…The diagnostic criteria for MRI are set in the cases of invasive abnormal placentation. The diagnostic accuracy of MRI is more in determination of posterior placentation 22 .…”

Section: Discussionmentioning

confidence: 99%

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Afridi¹,

Orakzai²,

Yasmeen³

et al. 2022

PJMHS

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“…To date, such a tool has not been developed; however, literature data indicate the potential value of 2-dimensional [16] and 3-dimensional Doppler ultrasonography to assess blood supply after myomectomy [17]. There are also opportunities for early detection by sequential MRI of the pregnant uterus [18]. Currently, we do not have methods and models that allow for the proper stratification of patients.…”

Section: Case Reportmentioning

confidence: 99%

Spontaneous uterine rupture during pregnancy after laparoscopic myomectomy – case report

Młodawski¹,

Bielak²,

Mlodawska³

et al. 2022

ppiel

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Herein we describe a case of spontaneous uterine rupture at 35 weeks of pregnancy in a 37-year-old female patient in her first pregnancy after in vitro fertilization, who had had a myomectomy 7 years earlier. The indication for the procedure was a myoma partially penetrating the uterine cavity (FIGO classification group 2-5) causing abnormal uterine bleeding. The myomectomy was performed by laparoscopy with layered suturing of the tumour bed. The patient came to the Obstetrics and Gynaecology Clinic due to increasing abdominal pain. Additional examinations revealed tenderness of the uterus, foetal tachycardia, and the presence of free fluid in the Douglas pouch during ultrasound examination. An urgent caesarean section was done, during which a full-walled uterine rupture was visualized at the fundus at the site of the tumour enucleation. Conservative treatment was chosen, leaving the uterus in place. The uterine muscle was sutured in layers. The postoperative period was uneventful. The patient was discharged home in good general condition.

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A common problem between gynecology, obstetrics, and reproductive medicine: Cesarean section scar defect

Lin,

Hou,

Chen

2024

Taiwanese Journal of Obstetrics and Gynecology

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Early identification of uterine scar defect by preconception magnetic resonance imaging to achieve successful pregnancy outcome after laparoscopic‐assisted myomectomy: Two case reports

Cited by 3 publications

References 21 publications

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Spontaneous uterine rupture during pregnancy after laparoscopic myomectomy – case report

A common problem between gynecology, obstetrics, and reproductive medicine: Cesarean section scar defect

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