scholarly journals The niche in the uterine cesarean scar: a new problem of women’s reproductive health

2020 ◽  
Vol 69 (1) ◽  
pp. 53-62
Author(s):  
Olga N. Nozhnitseva ◽  
Vitaliy F. Bezhenar

Hypothesis/aims of study. In the recent decades, the quality of uterine suture repair after a cesarean section is widely discussed, as local thinning of the myometrium forming uterine scar defects, or the so-called scar niche, are relatively common after the operation. The aim of this study was to identify the causes of local thinning of the uterine scar after cesarean section, to determine the effectiveness of existing methods for assessing the uterine scar in non-pregnant women, and to develop a method for surgical correction of this pathology. Study design, materials and methods. Over 4 years, 175 non-pregnant women with a uterine scar were examined. The 50 of them were diagnosed with the uterine scar niche, with a laparoscopic metroplasty performed in these patients. The effectiveness of the operation was evaluated in the long-term postoperative period. Results. Performing cesarean section because of weakness of labor activity and a complicated course of the postpartum period are significant factors in the formation of a uterine scar niche (p 0.05). Ultrasound examination and magnetic resonance imaging of the pelvic organs can be used to detect local thinning of the myometrium with a sensitivity of 82% and 96%, and a specificity of 85% and 90%, respectively. Conclusion. Metroplasty for patients with a diagnosed scar niche can significantly increase the thickness of the myometrium (p 0.05) and reduce the frequency of complaints of such menstrual irregularities as postmenstrual vaginal bleeding, dysmenorrhea, and hypermenorrhea (p 0.05).

Author(s):  
V.N. Demidov, A.I. Gus, T.A. Yarygina

Our statistical analysis, based on ultrasound examination of 7069 pregnant women, showed that both in the absence and in the presence of a scar on the uterus in the region of its lower segment, the placenta in the 3rd trimester of pregnancy was located extremely rarely, only in 0.1%. It was either primarily located in other parts of the uterus, or migrated from the lower segment of the uterus towards the bottom. In the case of the location of the placenta in this area, its ingrowth was not observed only in 2.3% of women. The main ultrasound signs of ingrowth of the placenta into the scar was the absence of its migration, as well as the presence of a combination of placenta previa with its localization in the scar zone. From the data obtained, it follows that the sensitivity of ultrasound diagnosis of placental accreta was 97.7%, and the specificity was 99.9%. According to our data, ingrown placenta in most cases can be delivered as early as 14–19 weeks, and the time spent on detecting this pathology usually does not exceed one minute.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Cuilan Li ◽  
Shiyan Tang ◽  
Xingcheng Gao ◽  
Wanping Lin ◽  
Dong Han ◽  
...  

Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum.Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS), and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery.Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05), respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40). Three patients (3/40 = 7.5%) developed partial improvement, and 1/40 (2.5%) was lost to follow-up.Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.


Author(s):  
Hande Nur Onur

A woman’s nutritional status prior to and during pregnancy affects foetal development, the course of the pregnancy and her long-term health. This study aims to determine the diets of pregnant and non-pregnant women using the Healthy Eating Index 2010 (HEI-2010). The study was performed on 43 non-pregnant and 25 pregnant volunteers, who had no chronic diseases, took no diet treatments and had a mean age of 23.0 ± 30.1 years. Their general features were determined through a questionnaire, dietary intake was measured by 24-hour dietary recall method, diet quality was assessed by HEI-2010 and energy and nutrient intake was calculated by the Nutrition Information System programme. The diet quality of 60.3% of the participants was found to be poor, while 39.7% was average. Although pregnant women had a slightly higher HEI-2010 score, the diet quality was low for all; hence, dieticians should provide nutrition education for all child-bearing aged women. Keywords: Diet quality, healthy eating index, pregnancy nutrition.


ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Guillaume Buiret ◽  
Clémentine Daveau ◽  
Guillaume Landry ◽  
Carole Colin ◽  
Jean-Christian Pignat ◽  
...  

Objective. To analyze the functional impact of the various possible treatments of oropharyngeal squamous cell carcinomas to find the main prognostic factors of dysphagia induced by these treatments. Patients. Clinical data from 254 patients treated for squamous cell carcinoma of the oropharynx between 1998 and 2003 were retrospectively analyzed. A multivariate model enabled us to evaluate the role of each potentially harmful factor on swallowing. Main Outcome Measures. The significant factors influencing the consumption of liquid, pasty, and normal food were the same: the initial T stage and the type of treatment. Conclusion. Whatever the possible and selected treatment was, the impact on the functional capacities, and thus, the quality of life of the patients was considerable. Even though we could not significantly demonstrate exclusive radiotherapy caused more long-term undesirable effects than surgery followed by radiotherapy, our daily practice has shown that we should favour the latter.


2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Megumi Kaneko ◽  
Yasuhiko Ebina ◽  
Nanae Shinozaki ◽  
Yui Yamasaki ◽  
Masashi Deguchi ◽  
...  

Abstract Massive subchorionic thrombosis (MST) is defined as a massive thrombosis under the chorionic plate, and is responsible for obstetric complications. We encountered two cases of MST. Placental abruption was misdiagnosed by ultrasound examination in Case 1, and a cesarean section was performed at 33 weeks of gestation. Magnetic resonance imaging (MRI) at 21 weeks of gestation suggested MST in Case 2. A cesarean section was performed at 26 weeks’ gestation because of pregnancy-induced hypertension, fetal growth restriction and non-reassuring fetal status.


2021 ◽  
Vol 9 (B) ◽  
pp. 48-54
Author(s):  
Saule Tulegenovna Sapiyeva ◽  
Nurkassi Tulepbergenovich Abatov ◽  
Makash Tynyshtykpaevich Aliyakparov ◽  
Yoshihiro Noso ◽  
Ruslan Muratovich Badyrov ◽  
...  

AIM: A new surgical method of non-tension autoplasty by displaced aponeurotic flap for the treatment of uncomplicated inguinal hernias has been developed. METHODS: Thirty patients were operated on using a new method of autoplasty; the comparison group involved 30 patients which were operated on by Liechtenstein hernioplasty using a partially absorbable mesh implant (UltraPro). The effectiveness of the methods was evaluated by clinical data, instrumental research methods (ultrasound examination, and computed tomography [CT]), and results of life quality. RESULTS: There were no relapse cases in both groups in the early and long-term after surgery. According to ultrasound, inflammatory infiltrate was absent in the group using a new autoplasty method, subclinical seromas resolved earlier after surgery. According to data of compression elastography and CT, the formation of a denser scar in the postoperative area was registered in the comparison group with a statistically significant difference. The feeling of discomfort and pain in the study group was more pronounced in the early post-operative period in comparison with the group using a mesh implant. However, in later terms, the life quality of patients in the group using a new autoplasty method improved with a statistically significant difference. CONCLUSION: The operation method is simple to perform, does not require the use of an endoprosthesis or extensive dissection of tissues and can be a reliable alternative and compete with prosthetic methods of hernioplasty.


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