Objective: To analyze the clinical features, diagnosis and treatment of gestational trophoblastic diseases in cesarean scar.
Methods: Clinical data of three cases of gestational trophoblastic diseases in cesarean scar diagnosed in Women's Hospital, Zhejiang University School of Medicine during December 2011 and December 2016 were collected. And literature search was performed in Wanfang data, VIP, CNKI, PubMed, ISI Web of Knowledge and EMbase database.
Results: A total of 20 cases of gestational trophoblastic diseases were included in the analysis. Clinical features were mainly abnormal vaginal bleeding after menopause, artificial abortion or medical abortion, which might be accompanied by abdominal pain. Serum β-human chorionic gonadotropin (β-hCG) levels were increased in 19 patients. The sonographic features were increase of uterine volume, honeycomb-like abnormal intrauterine echo (or described as multiple cystic dark area, multiple anechoic area and multiple liquid dark area) or heterogeneity echo conglomeration, and no clear bound with muscular layer in some cases. There were abundant blood flow signals inside or around the lesions. The ultrasonography indicated that the lesions were located in the anterior side of the uterine isthmus with the involvement of cesarean section scar. In 12 cases with lesions in cesarean scar shown by preliminary diagnosis, 9 underwent uterine artery embolization (UAE) for pretreatment; the blood loss greater than 1500 mL was observed in only one case without UAE; no patient received hysterectomy. In 8 patients whose lesions were not shown in cesarean scar, only one case received UAE pretreatment, and hysterectomy was performed in 3 cases due to blood loss greater than 1500 mL. Two cases were lost in follow-up and no death was reported in remaining 18 cases. The serum β-hCG levels returned to normal or satisfactory level during the follow-up in 17 cases with increased β-hCG levels before treatment and no recurrence was observed.
Conclusions: The misdiagnosis rate and missed diagnosis rate of gestational trophoblastic diseases in cesarean section scar are high. The identification of cesarean section scar involvement and UAE may reduce the bleeding and avoid hysterectomy.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10396901 | PMC |
| http://dx.doi.org/10.3785/j.issn.1008-9292.2017.10.13 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Risk factors associated with the failure of local methotrexate combined with minimally invasive surgery for late cesarean scar pregnancy.
BMC Pregnancy Childbirth
January 2025
Department of Gynecology, Shenyang Women's and Children's Hospital, No. 87 Renao Road, Shenyang, Liaoning Province, 110011, China.
Background: This study aimed to investigate the risk factors related to the failure of initial combined local methotrexate (MTX) treatment and minimally invasive surgery for late cesarean scar pregnancy (CSP).
Methods: This retrospective case-control study was conducted between January 2016 and December 2023, involving patients with late CSP (≥ 8 weeks) who received local MTX injection combined with either hysteroscopic or laparoscopic surgery. Cesarean scar pregnancy was classified as type I, II, or III based on the direction of growth of the gestational sac and the residual myometrial thickness as assessed by ultrasound.
Uterine artery embolization plus ultrasound guided curettage for cesarean scar pregnancy: Five-year experience at a single tertiary hospital.
Taiwan J Obstet Gynecol
January 2025
Department of Gynecology & Obstetrics, Beijing friendship hospital, Capital Medical University, No. 95, Yong'an Road, Xi-cheng district, Beijing, China. Electronic address:
Objective: To study immediate therapeutic outcomes, subsequent fertility effects and menstrual changes in cesarean scar pregnancy patients who received uterine artery embolization with or without methotrexate followed by ultrasound guided curettage.
Materials And Methods: Totally, 82 patients who met the inclusion criteria were enrolled in our study and divided into two groups. Group I included 50 patients who received uterine artery embolization and ultrasound guided curettage, and Group II had 32 patients who received uterine artery embolization plus methotrexate and ultrasound guided curettage.
Analysis and trends of caesarean sections using Robson's classification over 7-year period at a rural teaching hospital.
J Family Med Prim Care
December 2024
Department of Obstetrics and Gynecology, Society for Health Allied Research and Education, MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India.
Background: A ten-group classification system of caesarean section was proposed by Michael Robson in 2001. It is helpful in comparing the rates of caesarean section between hospitals. The objective of this study was to determine the caesarean section rates to analyse trends of caesarean section and classify according to Robson's categories.
View Article and Find Full Text PDFBiomimetic nanostructural materials based on placental amniotic membrane-derived nanofibers for self-healing and anti-adhesion during cesarean section.
Biomaterials
January 2025
Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China; Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan University, Guangzhou, 511462, China. Electronic address:
Cesarean section (CS) is highly prevalent surgery among females. However, current absorbable anti-adhesion membranes used clinically can partially prevent postoperative adhesions but show limited efficacy in tissue regeneration, leaving post-cesarean women at risk for severe complications including cesarean scar pregnancy, placenta previa, and uterine rupture. Herein, we designed a fully amniotic membrane (AM)-derived biomimetic nanostructural materials (AM-BNMs) as an anti-adhesion barrier, and validated its therapeutic efficacy in a rat CS model.
View Article and Find Full Text PDFAssociation Between Cesarean Scar and Pelvic Floor Muscle Tone at 6-8 Weeks Postpartum.
Int Urogynecol J
January 2025
Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, No. 128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China.
Introduction And Hypothesis: The relationship between cesarean section scars and active pelvic floor muscle tone lacks sufficient evidence. This study is aimed at investigating the relationship between the severity of cesarean section scars and active pelvic floor muscle tone in postpartum women.
Methods: We conducted a prospective cross-sectional study of 604 women at 6-8 weeks postpartum.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!