Clinical analysis of the preoperative condition and operative prognosis of post-cesarean section scar diverticulum: a case series.
Adult
Age Factors
Causality
Cesarean Section
/ adverse effects
China
Cicatrix
/ diagnosis
Diverticulum
/ diagnosis
Female
Fertility Preservation
/ methods
Humans
Hysteroscopy
/ adverse effects
Laparoscopy
/ adverse effects
Long Term Adverse Effects
Pregnancy
Preoperative Period
Severity of Illness Index
PCSD scoring
combined hysteroscopic and laparoscopic
factors influencing treatment efficacy
hysteroscopy
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
25 Oct 2020
25 Oct 2020
Historique:
received:
07
01
2020
accepted:
08
07
2020
pubmed:
10
8
2020
medline:
4
9
2021
entrez:
10
8
2020
Statut:
ppublish
Résumé
Objectives Post-cesarean section scar diverticulum (PCSD) is a long-term sequela of cesarean section (CS). The aim of this study was to evaluate the clinical utility of PCSD scoring criteria, and also retrospectively investigate the efficacy and fertility of two different surgical methods in 304 patients with PCSD. Methods A total of 304 PCSD patients who underwent hysteroscopy or combined hysteroscopy and laparoscopy (referred to as laparoscopy) in our hospital from 2016 to 2018 were retrospectively analyzed. Preoperative condition was analyzed by the PCSD scoring criteria and its influencing factors were explored. The efficacy, its influencing factors and pregnancy success rate of the two different surgical methods on PCSD was also analyzed after 6- and 12-months follow-up. Results PCSD was more severe (high score) in patients who experienced caesarean section with one of the following conditions: age >30 years old, without medical indications or retroflexed uterus. The postoperative efficacy of patients subjected to hysteroscopy or laparoscopy was 81.25 and 89.47% (after 6 months), and 79.53 and 87.50% (after 12 months), respectively. Hysteroscopic surgery was better for PCSD patients who had fewer CS and thicker residual muscle layer and worse for PCSD patients with a longer distance of incision defect to the end of the cervix. Postoperative fertilization showed that pregnancy success rate of patients subjected to hysteroscopy or laparoscopy was 56.2 and 50%, respectively. Conclusions The PCSD scoring is an effective method for assessing the severity of PCSD, and hysteroscopy and laparoscopy are effective modalities for PCSD. Hysteroscopy is also an option for patients with fertility needs.
Identifiants
pubmed: 32769225
doi: 10.1515/jpm-2020-0008
pii: jpm-2020-0008
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
803-810Références
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