Uterine dehiscence: a laparoscopic uterine repair in early pregnancy

Edwards, David R.; Mathur, Siddhi; Flores, Homero Flores; Whittle, Wendy; Murji, Ally

doi:10.1016/j.fertnstert.2022.05.039

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Data extraction was performed on the 100 articles that met inclusion criteria. These included four systematic reviews [3 [12][13][14][15][16][17][18]; two randomized control trials [19 ]; 12 video articles [62][63][64][65][66][67][68][69][70][71][72][73], 10 case reports [74][75][76][77][78][79][80][81][82][83]; one case series [84]; and 21 conference abstracts [64,. Excluding the conference abstracts, 25 countries were represented as the country of correspondence of the first author of the remaining 79 publications.…”

Section: Resultsmentioning

confidence: 99%

Emerging data on diagnosis and management of uterine isthmoceles: a rapid review

Cook,

Jesse,

Harvey

2024

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review With a rising number of cesarean sections, the prevalence of uterine isthmoceles is increasing. We performed a rapid review to assess the most recent data on the diagnosis and management of uterine isthmoceles over the past 18 months to identify current trends and directions for continued research. Recent findings A comprehensive search was conducted in PubMed (NLM), Embase (Ovid), CINAHL (EBSCOhost) to find English written articles discussing the diagnosis or management of uterine isthmoceles published in the previous 18 months. Data extraction was performed on one hundred articles that met inclusion criteria. Summary This rapid review highlights agreement regarding diagnostic methods, symptoms, and recommended treatment paths for patients with symptomatic uterine niches. However, the diversity in definitions hampers the capacity to formulate detailed conclusions regarding the features of uterine niches and their impact on women's health.

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Section: Resultsmentioning

confidence: 99%

Emerging data on diagnosis and management of uterine isthmoceles: a rapid review

Cook,

Jesse,

Harvey

2024

Current Opinion in Obstetrics &Amp; Gynecology

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“…3 For instance, in a recent report in Canada by Edwards et al , involving a 35-year-old, gravida 2, para 1 woman with a previous CS and presented at 10 weeks and 3 days gestational age with complete uterine dehiscence at the site of her previous CS scar, which was diagnosed by antenatal ultrasound, an ultrasound-guided laparoscopic repair was successfully done. 16 The treatment helped in demonstrating a restoration of approximately 8 mm of myometrial thickness across the cesarean scar defect on antenatal follow-up. The woman subsequently had a term live birth via CS.…”

Section: Discussionmentioning

confidence: 99%

Intra-operative Diagnosis of Lower Segment Scar Dehiscence in a Second Gravida After One Previous Lower Segment Cesarean Section: Should We Advocate for Routine Antenatal Uterine Scar Thickness Testing?

Eleje

Udigwe

Okafor

et al. 2023

Clin Med Insights Case Rep

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Background: Uterine dehiscence is a separation of uterine musculature with intact uterine serosa. It can be encountered at the time of cesarean delivery, suspected on obstetric ultrasound or diagnosed in-between pregnancies. The antenatal diagnosis may occasionally elude the Obstetricians. This particular case demonstrates an intra-operative diagnosis of uterine dehiscence with missed antenatal ultrasound diagnosis in an asymptomatic woman. Case presentation: She was a 32-year-old Nigerian second gravida who booked for antenatal care at 32 weeks of gestation following a referral from her attending Obstetrician from a neighboring state due to relocation. She had 3 antenatal visits and 2 antenatal ultrasound investigations without uterine scar thickness report. She subsequently had elective Cesarean section (CS) at a gestational age of 38 weeks plus 2 days due to persistent breech presentation on a background of a previous lower segment CS scar. There was no previous uterine curettage prior to or after the previous lower segment CS scar and there was no labor pains prior to the elective CS. The surgery was successful with intra-operative findings of moderate intra parietal peritoneal adhesions with rectus sheath and obvious uterine dehiscence along the line of the previous CS scar. The fetal outcomes were normal. Immediate post-operative condition was satisfactory and the woman was discharged on a third-day post operation. Conclusion: Obstetricians are charged to maintain a high index of suspicion when managing pregnant women with history of emergency CS in order to avert the adverse consequences of uterine rupture from asymptomatic uterine dehiscence. Based on this report, it may be useful to routinely assess the lower uterine segment scar of women with previous emergency CS using the available ultrasound facilities. However, more studies are needed before advocating for routine antenatal uterine scar thickness testing following emergency lower segment CS in low and middle-income settings.

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Prenatal Detection and Conservative Management of Uterine Scar Dehiscence in Patient with Previous Uterine Rupture and Multiple Surgeries—A Case Report

Zermano,

Seminara,

Parisi

et al. 2024

Healthcare

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Uterine rupture is a rare and life-threatening condition. It usually occurs in patients with uterine scars (most commonly for a previous myomectomy or caesarean section), but it can also affect an unharmed uterus. This complication is more frequent in the third trimester and during delivery. There is not yet a recognised method of prediction of uterine rupture and the ultrasound features still need a consensus. In this article, we have reported a case of uterine dehiscence diagnosed by a pelvic ultrasound and magnetic resonance (MRI) at 24 weeks of gestation. The finding was confirmed intraoperatively at the caesarean section at 29 weeks of gestation. The 40-year-old patient has had a previous pregnancy complicated by uterine rupture at 22 weeks of gestation, following six previous abdominal surgeries for stage IV endometriosis, diffuse and nodular adenomyosis, and pelvic adhesion syndrome. The early detection of uterine dehiscence allowed us to prolong the pregnancy and perform a subsequent fertility-sparing surgery, reducing maternal and neonatal morbidity and mortality. Our case report proves that women with severe endometriosis/adenomyosis are at a high risk of uterine rupture and scar dehiscence. The antenatal ultrasound can describe a uterine dehiscence (even in asymptomatic patients) and prevent complications.

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Uterine dehiscence: a laparoscopic uterine repair in early pregnancy

Cited by 3 publications

References 4 publications

Emerging data on diagnosis and management of uterine isthmoceles: a rapid review

Emerging data on diagnosis and management of uterine isthmoceles: a rapid review

Intra-operative Diagnosis of Lower Segment Scar Dehiscence in a Second Gravida After One Previous Lower Segment Cesarean Section: Should We Advocate for Routine Antenatal Uterine Scar Thickness Testing?

Prenatal Detection and Conservative Management of Uterine Scar Dehiscence in Patient with Previous Uterine Rupture and Multiple Surgeries—A Case Report

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