Uterine Isthmocele—A Frequently Overlooked Complication of Cesarean Sections

Rupa, Rosita; Kushvaha, Suchana; Venkatesh, Kiran

doi:10.1055/s-0041-1736393

Cited by 12 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of these increasing complications is isthmocele or uterine niche. This delayed complication is a pouch‐like diverticulum at the site of the previous CS scar on the anterior uterine wall 6,7 . The reported prevalences of isthmoceles in transvaginal ultrasound examinations of women with a history of one or more CS vary widely, ranging from 24% to 70%, likely due to the high frequency of asymptomatic cases 8–10 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of the clinical outcomes and complications of hysteroscopic and laparoscopic approaches in the treatment of symptomatic isthmocele: An observational study

Fatehnejad

Hadizadeh

Tayebi

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectivesTo investigate the outcomes of patients undergoing laparoscopic or hysteroscopic approaches for isthmoplasty.MethodsA total of 99 isthmocele patients with an average age of 38.45 ± 4.72 years were included in the 2 years of this retrospective cohort study. Forty‐five underwent laparoscopic and 54 underwent hysteroscopic isthmocele excision and myometrial repair.ResultsPain scores were significantly higher in the hysteroscopy group before the procedure, but there were no significant pain score differences after the surgery. In 1 year of follow up, dysmenorrhea and dyspareunia were higher among hysteroscopy patients. Furthermore, hysteroscopy significantly improved postmenstrual spotting after surgery better than laparoscopy, but in the follow up, there was no significant difference between the two groups in this regard (mean rank for hysteroscopy vs. laparoscopy: 32.30 vs. 37.48, U = 418, P = 0.29).ConclusionIn patients with a history of infertility, ectopic pregnancy, lower gravidity, lower parity, and a lower number of cesarean sections, laparoscopic isthmoplasty is preferred over the hysteroscopic approach. Both methods have similar effects on midcycle vaginal bleeding, duration of postmenstrual spotting, and pain. However, a higher rate of dyspareunia and dysmenorrhea could be associated with hysteroscopy.

show abstract

Section: Introductionmentioning

confidence: 99%

“…This delayed complication is a pouch-like diverticulum at the site of the previous CS scar on the anterior uterine wall. 6,7…”

mentioning

confidence: 99%

Assessment of the clinical outcomes and complications of hysteroscopic and laparoscopic approaches in the treatment of symptomatic isthmocele: An observational study

Fatehnejad

Hadizadeh

Tayebi

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…The incidence of CS scars with an apparent defect has been reported to range from 6.9% to 69%. 1 As the incidence of cesarean section increases, 2 we have seen a parallel increase in scar related complications. An isthmocele is caused by weakening of a cesarean section scar resulting in outpouching of the uterine wall.…”

Section: Introductionmentioning

confidence: 99%

Isthmocele abscess: A rare case report

Warrier,

Warrier

2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…Previous research has been directed towards the impact of the CS scar and the isthmocele. Isthmocele is a defect which measures 1–2 mm or seen as a hypoechoic triangle in the anterior myometrium at the site of lower segment cesarian section scar [ 8 ]. Prior research has examined the association of isthmocele and pregnancy outcome among patients undergoing IVF [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Intra-cavitary fluid resulted from caesarean section but not isthmocele compromised clinical pregnancy after IVF/ICSI treatment

Cai

Pan

Xia

et al. 2022

Arch Gynecol Obstet

View full text Add to dashboard Cite

The aim of this study was to explore whether the presence of intra-cavitary fluid (ICF) influences the pregnancy outcomes of patients with caesarean section (CS) in embryo transfer cycles. A total of 8494 transferred cycles of 4924 women were enrolled in this retrospective study and separated into three subgroups by previous delivery method and the presence of intra-cavity fluid, a caesarean group with ICF (CS-ICF, n = 649), a caesarean group without ICF (CS-noICF, n = 3207), and the remaining 4638 cycles without ICF were included in the vaginal delivered group (VD, n = 4638). Baseline characteristics and clinical outcome were compared. Propensity score matching (PSM) was conducted to adjust confounding factors between groups. Patients in the CS-ICF group were of younger age (36.49 ± 4.19 vs 37.34 ± 4.25, 37.32 ± 4.86, P < 0.001), had better ovary reserve, and had more blastocyst transferred compared with the CS-noICF and VD groups. However, cycles in the CS-ICF group achieved unsatisfactory clinical pregnancy outcomes. PSM analysis for comparability and differences in clinical outcomes still existed. The clinical pregnancy rate was significantly lower in the CS-ICF group than in the CS-noICF group (35.1% vs 41.7% for CS-noICF group, 48.1% for VD group, P < 0.001). Subgroup analysis of fresh embryo transferred cycles, the differences in clinical outcomes disappeared after PSM analysis, while the clinical pregnancy rate was still lowest among the three matched groups of FET cycles (36.4% vs 50.3% for VD group, P < 0.001). The presence of intra-cavitary fluid (ICF), but not necessarily the isthmocele, significantly compromises the clinical pregnancy rate in patients with previous CS undergoing IVF/ICSI treatment.

show abstract

Uterine Isthmocele—A Frequently Overlooked Complication of Cesarean Sections

Cited by 12 publications

References 19 publications

Assessment of the clinical outcomes and complications of hysteroscopic and laparoscopic approaches in the treatment of symptomatic isthmocele: An observational study

Assessment of the clinical outcomes and complications of hysteroscopic and laparoscopic approaches in the treatment of symptomatic isthmocele: An observational study

Isthmocele abscess: A rare case report

Intra-cavitary fluid resulted from caesarean section but not isthmocele compromised clinical pregnancy after IVF/ICSI treatment

Contact Info

Product

Resources

About