A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section
Introduction: A caesarean scar defect (isthmocele) is an indentation that represents myometrial discontinuity in the anterior uterine wall, with the base communicating with the uterine cavity at the site of a previous caesarean section scar. It has been linked to a variety of gynaecological symptoms...
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JCDR Research and Publications Private Limited
2025-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/20577/73896_CE[Ra1]_F(SHU)_QC(AN_SHU)_PF1(JY_SS)_PFA(IS)_PB(JY_IS)_PN(IS).pdf |
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| author | Maneesha Shrivastava Varuna Pathak Sushruta Shrivastava |
| author_facet | Maneesha Shrivastava Varuna Pathak Sushruta Shrivastava |
| author_sort | Maneesha Shrivastava |
| collection | DOAJ |
| description | Introduction: A caesarean scar defect (isthmocele) is an indentation that represents myometrial discontinuity in the anterior uterine wall, with the base communicating with the uterine cavity at the site of a previous caesarean section scar. It has been linked to a variety of gynaecological symptoms, including abnormal uterine bleeding and secondary infertility.
Aim: To describe the demographic characteristics, clinical presentation, management and outcomes in patients with Caesarean Scar Defect (CSD).
Materials and Methods: A retrospective cohort analysis was conducted in the Department of Obstetrics and Gynaecology, Gastrocare Hospital (tertiary care centre), Bhopal, Madhya Pradesh, India, from February 2020 to February 2023. Data were collected from the hospital records of 43 patients who presented with CSD. The recorded variables included demographic details, clinical presentations, prior treatments, diagnostic interventions, types of surgical procedures performed and patient outcomes. Descriptive statistics, such as means, standard deviations and frequencies, were used to summarise patient characteristics and outcomes. All statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) software version 29.0 software.
Results: The majority of the women were in the age group of 30-40 years. Out of 43 patients, eight presented with Abnormal Uterine Bleeding (AUB), three had secondary infertility, and 32 presented with Caesarean Scar Ectopic Pregnancy (CSEP) and its complications. All cases were managed either by hysteroscopy or laparoscopy, based on the Residual Myometrium Thickness (RMT).
Conclusion: Transvaginal Sonography (TVS) is an effective tool for diagnosing CSD and CSEP. Surgical management can be guided by the RMT as determined by TVS. |
| format | Article |
| id | doaj-art-8d885b3c3a72451794fd794b996ab763 |
| institution | Kabale University |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-8d885b3c3a72451794fd794b996ab7632025-02-04T12:13:47ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-02-011902060910.7860/JCDR/2025/73896.20577A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean SectionManeesha Shrivastava0Varuna Pathak1Sushruta Shrivastava2Consultant, Department of Gynaecology, Gastrocare Hospital, Bhopal, Madhya Pradesh, India.Professor, Department of Obstetrics and Gynaecology, RKMCHRC, Bhopal, Madhya Pradesh, IndiaAssociate Professor, Department of Obstetrics and Gynaecology, RKMCHRC, Bhopal, Madhya Pradesh, India.Introduction: A caesarean scar defect (isthmocele) is an indentation that represents myometrial discontinuity in the anterior uterine wall, with the base communicating with the uterine cavity at the site of a previous caesarean section scar. It has been linked to a variety of gynaecological symptoms, including abnormal uterine bleeding and secondary infertility. Aim: To describe the demographic characteristics, clinical presentation, management and outcomes in patients with Caesarean Scar Defect (CSD). Materials and Methods: A retrospective cohort analysis was conducted in the Department of Obstetrics and Gynaecology, Gastrocare Hospital (tertiary care centre), Bhopal, Madhya Pradesh, India, from February 2020 to February 2023. Data were collected from the hospital records of 43 patients who presented with CSD. The recorded variables included demographic details, clinical presentations, prior treatments, diagnostic interventions, types of surgical procedures performed and patient outcomes. Descriptive statistics, such as means, standard deviations and frequencies, were used to summarise patient characteristics and outcomes. All statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) software version 29.0 software. Results: The majority of the women were in the age group of 30-40 years. Out of 43 patients, eight presented with Abnormal Uterine Bleeding (AUB), three had secondary infertility, and 32 presented with Caesarean Scar Ectopic Pregnancy (CSEP) and its complications. All cases were managed either by hysteroscopy or laparoscopy, based on the Residual Myometrium Thickness (RMT). Conclusion: Transvaginal Sonography (TVS) is an effective tool for diagnosing CSD and CSEP. Surgical management can be guided by the RMT as determined by TVS.https://jcdr.net/articles/PDF/20577/73896_CE[Ra1]_F(SHU)_QC(AN_SHU)_PF1(JY_SS)_PFA(IS)_PB(JY_IS)_PN(IS).pdfcaesarean scar defecthysteroscopic managementlaparoscopic approachmethotrexatescar ectopic pregnancy |
| spellingShingle | Maneesha Shrivastava Varuna Pathak Sushruta Shrivastava A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section Journal of Clinical and Diagnostic Research caesarean scar defect hysteroscopic management laparoscopic approach methotrexate scar ectopic pregnancy |
| title | A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section |
| title_full | A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section |
| title_fullStr | A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section |
| title_full_unstemmed | A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section |
| title_short | A Retrospective Descriptive Study on Caesarean Isthmocele: A Delayed and Under-recognised Complication of Caesarean Section |
| title_sort | retrospective descriptive study on caesarean isthmocele a delayed and under recognised complication of caesarean section |
| topic | caesarean scar defect hysteroscopic management laparoscopic approach methotrexate scar ectopic pregnancy |
| url | https://jcdr.net/articles/PDF/20577/73896_CE[Ra1]_F(SHU)_QC(AN_SHU)_PF1(JY_SS)_PFA(IS)_PB(JY_IS)_PN(IS).pdf |
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