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剖宫产瘢痕缺损

[Cesarean scar defect].

作者信息

Melo-Cerda Isaac

出版信息

Ginecol Obstet Mex. 2014 Aug;82(8):530-4.

Abstract

BACKGROUND

Caesarean section has immediate complications and traditional, well known later, but of equal or greater importance are the risks for the next pregnancy, due to the possibility of uterine rupture, placenta accreta, placenta previa, pregnancy or cervical scar hysterorrhaphy, and other complications not well disseminated or known defects associated with scar hysterorrhaphy (dehiscence).

OBJECTIVE

Show off frequency and caracteristics of the cesarean scar defects.

MATERIAL AND METHOD

Retrospective and observational study, by reviewing videos of patients subjected to exploration of the endocervical canal and uterine cavity whith hysteroscope in a 5 year period, in patients with a history of previous cesarean section, evaluating the integrity of the scar. The defects were classified into three categories according to the depth of the defect.

RESULTS

Patients with previous c-section, 62.5% had a defect of the closure of the scar. The total dehiscence of the muscular layer was found in patients with 1, 2 and 3 or more c-section, and only 3 cases (12%) of the defects were found at the level of the isthmus.

CONCLUSION

Cesarean scar defects are more frequent than we assumed. Since they favour obstetric and gynecological obstetric pathology, with the increase in the number of patients who undergo caesarean section, this has become a health problem, and we must know and promote its relationship with abnormal uterine bleeding and secondary sterility.

摘要

背景

剖宫产有直接并发症,传统上其远期并发症也广为人知,但由于存在子宫破裂、胎盘植入、前置胎盘、妊娠或宫颈瘢痕子宫出血以及其他未广泛传播或鲜为人知的与瘢痕子宫出血(裂开)相关的并发症的可能性,下一胎妊娠的风险同样重要甚至更重要。

目的

展示剖宫产瘢痕缺陷的发生率及特征。

材料与方法

回顾性观察研究,通过查看5年间有剖宫产史患者经宫腔镜检查宫颈管和子宫腔的视频,评估瘢痕的完整性。根据缺陷深度将缺陷分为三类。

结果

有剖宫产史的患者中,62.5%存在瘢痕闭合缺陷。在有1次、2次及3次或更多次剖宫产的患者中发现了肌层完全裂开,仅3例(12%)缺陷位于峡部水平。

结论

剖宫产瘢痕缺陷比我们预想的更常见。由于它们易引发妇产科产科病理问题,随着剖宫产患者数量的增加,这已成为一个健康问题,我们必须了解并推动其与异常子宫出血和继发性不孕的关系。

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