Recurrent massive uterine bleeding from a cesarean scar treated successfully by laparoscopic surgery

Mariya, Tasuku; Umemoto, Mina; Sugita, Naoko; Suzuki, Masahiro; Saito, Tsuyoshi

doi:10.4103/gmit.gmit_69_18

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…When it ruptures, the aneurysm structure may no longer exist; at this time, the angiographic evidence shows extravasation, but there is no "obvious" capsule.The detection of atypical pseudoaneurysms by ultrasound indicated a low/high ultrasound mass with rich blood ow signals in the uterus [11]. In our case, ultrasound and MRI showed a diverticulum without abnormal blood ow signals around it, as Tasuku or Chin reported [4,6]. Vascular hyperplasia in the diverticulum is obvious and even extends to the posterior part of the cervix under hysteroscopy, which is a typical manifestation of in ammation.…”

Section: Discussionsupporting

confidence: 53%

Recurrent Massive hemorrhage from Cesarean Scar defect: a case report and literature review

Zhao

Dai

Wang

et al. 2023

Preprint

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Cesarean section (CD) is one of the most common operations in the world. Cesarean scar defect (CSD), one of the recently discovered complications of cesarean section, has been found to be related to abnormal uterine bleeding. Massive hemorrhage caused by CSD has rarely been reported. The cause is still unknown, and the treatments vary.We report a case of a 37-year-old woman who experienced prolonged menstruation for 6 years after her second cesarean section. She had recurrent sudden massive hemorrhage and nothing abnormal was observed by ultrasound or MRI examination except for CSD. The patient underwent hysteroscopic surgery. The abnormal uterine bleeding was successfully stopped, and the menstrual cycle returned to normal after surgical treatment. Diverticulum with abnormal bleeding symptoms may induce massive hemorrhage. Patients with the same syndrome should be informed of the risk. Hysteroscopy surgery could be a choice.

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Section: Discussionsupporting

confidence: 53%

Recurrent Massive hemorrhage from Cesarean Scar defect: a case report and literature review

Zhao

Dai

Wang

et al. 2023

Preprint

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“…The scar itself as a source of bleeding is supposedly another possible cause for abnormal bleeding post-cesarean. The formation of abnormal blood vessels in the area of the scar which can than cause somewhat heavy bleeding could explain the symptoms [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The association between gynecological complaints and the uterine sonographic features in women with a history of cesarean section

Kellner,

Horky,

Louwen

et al. 2024

Arch Gynecol Obstet

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Purpose The aim of this study is to investigate the association between post-cesarean sonographic uterine measures, dysmenorrhea, and bleeding disorders. Methods This is a cross-sectional study where 500 women with a history of only one cesarean section (CS) were recruited. A transvaginal transducer, GE RIC6-12-D was used for the acquisition of volumetric datasets 18 ± 7 months postpartum. Uterine length (UL), cervical length (CL), niche length (L), niche depth (D), niche width (W), fibrosis length (FL), fibrosis depth (FD), residual myometrial thickness (RMT), endometrial thickness (EM), scar to internal os distance (SO), anterior myometrial thickness superior (sAMT) and inferior (iAMT) to the scar, and the posterior myometrial thickness opposite the scar (PMT), superior (sPMT), and inferior to it (iPMT) were measured. Logistic regression with odds ratios (OR), 95% confidence intervals (CI) and ROC curves were utilized. Results The proportion of patients with incident post-cesarean bleeding disorders and dysmenorrhoea was 36% (CI 32%, 40%) and 17% (CI 14%, 21%) respectively. Univariate logistic regression showed that only UL was associated with bleeding disorders [OR 1.04 (CI 1.01,10.7) p value 0.005], whereas dysmenorrhea was associated with RMT [OR 0.82 (CI 0.71,0.95) p value 0.008], SO [OR 0.91 (CI 0.86,0.98) p value 0.01], and RMT ratio [OR 0.98 (CI 0.97,0.99) p value 0.03]. Multivariate logistic regression for dysmenorrhoea including SO and RMT remains statistically significant with p values <0.05 and area under the curve of 0.66. Conclusion There is an association between sonographic appearance of CS scars and dysmenorrhoea. Nevertheless, the association is weak and other biological post-cesarean characteristics should be explored as potential causes.

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Comparative Study of USG and MRI in Evaluation of Isthmocele

Gupta

Singal

Gupta

et al. 2021

J Obstet Gynecol India

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Recurrent massive uterine bleeding from a cesarean scar treated successfully by laparoscopic surgery

Cited by 4 publications

References 10 publications

Recurrent Massive hemorrhage from Cesarean Scar defect: a case report and literature review

Recurrent Massive hemorrhage from Cesarean Scar defect: a case report and literature review

The association between gynecological complaints and the uterine sonographic features in women with a history of cesarean section

Comparative Study of USG and MRI in Evaluation of Isthmocele

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