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Laparoscopic correction of isthmocele combined with ventrosuspensios of uterus


Authors: K. Šubová 1;  Martin Němec 1 ;  R. Pilka 2
Authors place of work: Gynekologicko-porodnické oddělení Nemocnice, Frýdek-Místek, primář MUDr. M. Němec 1;  Porodnicko-gynekologická klinika LF UP a FN, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. 2
Published in the journal: Ceska Gynekol 2020; 85(2): 104-110
Category: Kazuistika

Summary

Objective: To describe a case history of a patient after two caesarean sections, planning another pregnancy. Due to the dehiscent lower uterine segment, surgical correction of the defect was performed. Performance followed by an unplanned pregnancy five weeks after the operation.

Design: Case report.

Setting: Department of Obstetrics and Gynaecology, Hospital in Frýdek-Místek.

Case report: We present a case of a 31-year-old third-graders, anamnestically after two caesarean sections, which were performed laparoscopical correction of isthmocoele in our department. Our patient was diagnosed with six weeks old intrauterine pregnancy only eleven weeks after surgery. The gravidity was successfully completed in the 38th week of pregnancy by the planned caesarean section with finding of a solid lower uterine segment. Whole duration of the pregnancy was uncomplicated.

Conclusion: Women, after previous surgery of the uterus, are exposed to complications such as nidation disorders, placental disorders, risk of uterine rupture etc. during future pregnancy and childbirth. We want to show possible advantage of laparoscopic isthmocoele resection in combination with ventrosuspension of uterus.

Keywords:

isthmocoele – laparoscopy – caesarean section – uterine rupure


Zdroje

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3.    Donnez, O., Donnez, J., Orellana, R., et al. Gynecological and obstetrical outcomes after laparoscopic repair of a cesarean scar defect in a series of 38 women. Fertil Steril, 2017, 107(1), p. 289–296.e2.

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12.  Setubal, A., Alves, J., Osorio, F., et al. Treatment for uterine isthmocele, a pouchlike defect at the site of a cesarean section scar. J Minim Invasive Gynecol, 2018, 25(1), p. 38–46.

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15.  Vandenberghe, G., De Blaere, M., Van Leeuw, V., et al. Nationwide population-based cohort study of uterine rupture in Belgium: results from the Belgian Obstetric Surveillance System. BMJ Open, 2016, 6:e010415. doi: 10.1136/bmjopen-2015-010415

16.  Van der Voet, LF., Vervoort, AJ., Veersema, S., et al. Minimally invasive therapy for gynaecological symptoms related to a niche in the caesarean scar: a systematic review. BJOG, 2014, 121, p. 145–156.

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Štítky
Dětská gynekologie Gynekologie a porodnictví Reprodukční medicína

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Česká gynekologie

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2020 Číslo 2
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