Laparoscopic Ultrasound-Guided Repair of Uterine Scar Isthmocele Connected With the Extra-Amniotic Space in Early Pregnancy

Bolla, Daniele; Raio, Luigi; Favre, D; Papadia, Andrea; In-Albon, Sarah; Mueller, Christoph

doi:10.1016/j.jmig.2015.09.010

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…To our knowledge, there is one more case reported at first trimester which is a uterine scar isthmocele that was repaired with ultrasoundguided laparoscopic surgical management, and the pregnancy continued until 38 weeks. 7 No treatment plan has been clarified in uterine rupture cases at gestational ages of fetal viability limit. Shiratani et al reported that they repaired the area with fleece-coated fibrin glue in combination with closing the ruptured area by absorbable suture of a case who was admitted with hemoperitoneum in week 24 of the gestation, thus the pregnancy is prolonged until 35 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Turkiye 7 There are few reported cases of first trimester uterine dehiscence associated with surgical abortion or following incomplete abortion. However, there is not any ongoing pregnancy among these cases.…”

Section: Discussionmentioning

confidence: 99%

“…The successful outcome of Bolla et al case is spectacular for this reason. 7 Vikhareva et al identified the caesarean scar defects with regard to their size in 108 patients who have undergone caesarean, but they didn't report complete dehiscence in any case. 12 Considering the published data concerning the diagnosis and treatment of the cesarean section scar defects, there is no dehiscence case among nonpregnant women included into the studies.…”

Section: Discussionmentioning

confidence: 99%

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Repair of a First Trimester Uterine Dehiscence with Continuation of Pregnancy: Case Report

Sanverdi¹,

Ayvaci²,

Temizkan³

et al. 2017

Turkiye Klinikleri J Case Rep

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pontaneous uterine rupture and dehiscence are rare complications of pregnancy. While uterine rupture refers to full thickness disruption of the uterine wall, uterine dehiscens is an incomplete separation of the uterine wall with intact serosa.The dehiscence of a uterus in fetal viability limit creates a dilemma because there is not any clear treatment approach.1 Although rare, pregnancy continuation with the expectant approach or defect repair in the second trimester has been published. 2,3 Also, there are few reported cases of first trimester uterine dehiscence associated with surgical abortion or following incomplete abortion. While uterine rupture refers to full thickness disruption of the uterine wall, uterine dehiscens is an incomplete separation of the uterine wall with intact serosa. The dehiscence of a uterus in fetal viability limit creates a dilemma because there is not any clear treatment approach. Although rare, pregnancy continuation with the expectant approach or defect repair in the second trimester has been published. We report a first trimester uterine scar dehiscence. Ultrasound examination during valsalva maneuver and synchronous elevation of uterus by manual examination helped us in correct diagnosis. The dehiscence has been repaired with laparotomy and the pregnancy continued until 32 weeks of gestation.K Ke ey yw wo or rd ds s: : Pregnancy trimester, first; uterine rupture Ö ÖZ ZE ET T Uterus ruptürü ve dehisensi gebeliğin nadir komplikasyonlarındandır. Uterin ruptürde uterusa ait tüm katlar ayrışırken, uterus dehisensinde seroza bütünlüğünü korumakta ve bu duruma kısmi bir ayrışma eşlik etmektedir. Fetal viabilite için sınır olan haftalar ve öncesinde ortaya çıkan bir uterus dehisensi tedavi yaklaşımında netlik olmadığı için gebeliğin takibinde ikilem yaratmaktadır. Nadir olsa da, ikinci trimester dehisens olgularında beklemenin tercih edilmesi ya da uterusun onarımı sonrasında devam eden gebelik olguları bildirilmişir. Bu olguda birinci trimester bir gebelikte uterin dehisens olgusu sunduk . 31 yaşında, geçirilmiş 2 sezaryen öyküsü olan hastanın ultrasonografi eşliğinde yapılan muayenesinde, valsalva manevrası esnasında amniyotik kesenin eski insizyon hattından mesaneye doğru protrude olduğu izlendi. Dehisens laparotomi ile onarıldı, gebelik 32 haftaya dek devam etti.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Gebelik trimesteri, birinci; uterus rüptürü

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Repair of a First Trimester Uterine Dehiscence with Continuation of Pregnancy: Case Report

Sanverdi¹,

Ayvaci²,

Temizkan³

et al. 2017

Turkiye Klinikleri J Case Rep

View full text Add to dashboard Cite

show abstract

“…[7][8][9] However, expectant management with ultrasound surveillance and conservative surgery with pregnancy continuation has been successful. 4,[10][11][12][13][14][15] We present a case of bovine pericardial graft used to repair cesarean scar dehiscence at 23 weeks of gestation.…”

Section: Casementioning

confidence: 99%