Background: An isthmocele is a scar defect in the uterine wall due to a cesarean section. Its prevalence is unknown, but it has been associated with secondary infertility. Here, we present a case where the patient suffered from an isthmocele that was associated with persistent hydrometra, which developed during fertilization.
Case Summary: The patient underwent hysteroscopic surgery, which successfully resolved the isthmocele as well as the hydrometra. Afterward, two high-quality, euploid embryos, determined by morphological assessment and pre-implantation genetic diagnostic testing, were transferred. This resulted in uterine pregnancy, as determined by serum β-human chorionic gonadotropin levels on day 14 (180 mU/mL) and ultrasound-confirmed presence of a gestational sac with a positive embryocardia at week 6. The pregnancy reached 36 wk without any complications, and the product was born in good health. We report a successful isthmocele treatment in a patient with secondary infertility, in which the isthmocele was the cause of persistent hydrometra.
Conclusion: Hydrometra caused by secondary cesarean is an infertility factor, which can be corrected by hysteroscopy plus ablation of the isthmocele.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448083 | PMC |
| http://dx.doi.org/10.12998/wjcc.v7.i6.753 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Histopathologic patterns in isthmocele pregnancies.
Ann Diagn Pathol
January 2025
Latifa Hospital, Dubai, United Arab Emirates.
Isthmoceles are defects related to Caesarean section (CS) scars, known to cause secondary infertility and interfere with in-vitro fertilization in women who have had Caesarean deliveries. The etiologies are multifactorial. Isthmoceles, similar to dehiscent CS scars, can be potential sites for ectopic pregnancies and abnormal placentation.
View Article and Find Full Text PDFBackground Uterine isthmocele, a defect in the uterine wall at the cesarean scar, is increasingly recognized due to the rising rate of cesarean deliveries. Often asymptomatic, it may lead to complications such as abnormal bleeding, chronic pelvic pain, secondary infertility, or uterine rupture during subsequent pregnancies. Objective This study aimed to assess the prevalence, clinical features, and associated risk factors of uterine isthmocele among women with previous cesarean scars over four years (2019-2023) at Rabia Balkhi Hospital, Afghanistan.
View Article and Find Full Text PDFCurrent surgical treatment of uterine isthmocele: an update of existing literature.
Arch Gynecol Obstet
December 2024
Department of Obstetrics and Gynecology, Spital Männedorf, 8708, Männedorf, Switzerland.
Article Synopsis
- The rise of uterine isthmocele, tied to increasing cesarean section rates, affects about 60% of women with cesarean histories, leading to its classification as cesarean scar disorder (CSD).
- Diagnosis is achievable through various imaging techniques, and management may involve either pharmacological or surgical options.
- Surgical treatments, such as hysteroscopic resection, laparoscopic, and vaginal methods, vary in effectiveness and complications, with hysteroscopic treatment being the safest, although decisions should be tailored to individual patient factors, particularly residual myometrial thickness (RMT).
Reproductive outcomes after surgical resection of isthmocele in secondary infertility.
Int J Gynaecol Obstet
December 2024
Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland.
Objectives: To evaluate the reproductive outcomes after different approaches of surgical isthmocele excision in women with secondary infertility.
Methods: The present study was conducted between November 2017 and February 2023 in the Department of Gynecological Endocrinology and Gynecology at Jagiellonian University Medical College, Krakow, Poland. Women with large isthmocele with residual myometrial thickness (RMT) <3 mm and secondary infertility were included in this retrospective study.
A feasible procedure for laparoscopic cesarean scar defect repair.
Am J Obstet Gynecol
October 2024
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China. Electronic address:
Article Synopsis
- * Surgical options for CSD repair include hysteroscopic, transabdominal (laparotomy, laparoscopic, robotic), and vaginal techniques, with laparoscopic methods preferred for symptomatic patients with thin myometrial thickness.
- * A video illustrates a new laparoscopic technique for CSD repair using a uterine manipulator for better visualization and temporary artery occlusion to reduce bleeding, leading to successful symptom relief and pregnancy in a patient post-surgery.
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!