First‐trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar

Jurkovic, D.; Hillaby, K.; Woelfer, B.; Lawrence, Alexandra; Salim, Rehan; Elson, C. J.

doi:10.1002/uog.56

Cited by 684 publications

(561 citation statements)

References 21 publications

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“…With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The incidence of CS ectopic pregnancy varies from 1:1800 to 2216 pregnancies with rate of 0.15 % in women with previous caesarean section and 6.1 % of all ectopic pregnancies [2,3]. In 2012, Shen et al [4], in their series of 45 patients with CS ectopic pregnancies, in which 42 women (93.3 %) had undergone only one caesarean section, concluded that multiple caesarean sections may not increase the risk of this condition.…”

Section: Introductionmentioning

confidence: 99%

Scar Ectopic Pregnancy

Patel

2015

J Obstet Gynecol India

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Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management can prevent pregnancy complications such as haemorrhage, uterine rupture and can preserve fertility.

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Section: Introductionmentioning

confidence: 99%

Scar Ectopic Pregnancy

Patel

2015

J Obstet Gynecol India

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“…CS scar endometriosis (2 cases) is very rare; however, it could be associated with uterine adenomyosis and can be Ectopic pregnancy or complicated ectopic pregnancy of the CS scar (4 cases) can be seen as a cystic lesion representing the gestational sac with or without a fetal node inside and could represent a medical emergency [10][11][12][13][14][15].…”

Section: Cervical Nabothian Cysts (Fig 6)mentioning

confidence: 99%

Endosonography of benign myometrium cysts and cyst-like lesions

Youssef

2014

J Ultrasound

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Introduction Many pathological causes are responsible for the sonographic presentation of myometrium cysts and cyst-like lesions, where the distinction between these etiologies is required. The aim of the work The current work is aimed at discerning between different etiologies of myometrium cysts and cyst-like lesions for an optimum management. Methodology In the course of daily practice of gynecological transvaginal ultrasound, 66 cases of myometrium cysts and cyst-like lesions have been discerned, where all were examined with endovaginal ultrasound using a multifrequency endocavitary probe having color Doppler capability. Results Adenomyosis uteri detected in 15 cases, invasive mole in 4 cases, congested arcuate veins in 20 cases, incidental cysts in 4 cases, cystic degeneration of myoma in 3 cases, C-section scar cysts and cyst-like lesions in 13 cases, interstitial ectopic pregnancy in 2 cases, incomplete abortion with congested myometrium vessels in 4 cases, and arteriovenous malformation in 1 case. The number of cases with cervical nabothian cysts was not considered since they were too frequent. Conclusion Endosonography is an important tool in differentiating between the various diseases that are responsible for benign myometrium cysts and cyst-like lesions, which are all important since some of them are visualized as serious clinical situations and others turn out to be of little clinical significance.Keywords Endosonography Á Myometrium Á Cysts Á Adenomyosis Riassunto Introduzione Molte patologie sono responsabili della presentazione ecografica di cisti del miometrio e di lesioni simil-cistiche ed è necessaria la distinzione tra le varie eziologie. Scopo del lavoro Scopo del lavoro è distinguere tra le diverse eziologie delle cisti del miometrio e delle lesioni simil-cistiche per una loro gestione ottimale. Materiali e metodi Durante la pratica quotidiana di ecografia transvaginale ginecologica sono stati riscontrati 66 casi di cisti del miometrio e di lesioni simil-cistiche, tutti sono stati esaminati con ecografia endovaginale con sonda endocavitaria multifrequenza e modulo Doppler. Risultati In 15 casi è stata rilevata adenomiosi dell'utero, in 4 casi mola invasiva, in 20 casi congestione venosa, in 4 casi riscontro incidentale di cisti, in 3 casi degenerazione cistica dei miomi, in 13 casi cicatrice cistica (CS) e lesioni simil-cistiche, in 2 casi gravidanza ectopica, in 4 casi aborto incompleto con vasi del miometrio congestionati e in 1 caso malformazioni artero-venose. I casi di cisti Naboth non sono stati considerati in quanto di troppo frequente riscontro. Conclusioni L'ecoendoscopia è uno strumento importante nella differenziazione delle varie malattie che sono responsabili della formazione di cisti benigne del miometrio come di lesioni simil-cistiche, alcune gravi, altre di scarsa rilevanza clinica.

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“…We have already learned that, similar to other non‐tubal ectopics, 40–50% of these pregnancies fail during the first trimester, but a significant proportion has a potential to progress further 3 .…”

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confidence: 96%

“…These defects typically communicate widely within the cervical canal, creating a characteristic “niche” in which pregnancy may implant 1 , 2 . Despite a relatively large number of women with deficient Caesarean scars in the population, implantation of pregnancy in this defect is relatively rare 3 . 4 .…”

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confidence: 99%