Original techniques for niche correction after two cesarean sections
Background. It is important to develop new methods for correcting the postoperative uterine scar niche after cesarean section.Reznik V.A., Malysheva A.A., Matukhin V.I., Rukhliada N.N., Taits A.N.
Case report. The paper describes a case of a 27-year-old patient with a history of two previous caesarean sections. Transvaginal ultrasound and MRI revealed two postcesarean uterine scar defects at different levels: in the isthmus area and at 15 mm above the level of 17.0 and 13.6 mm internal orifices with the residual myometrial thickness above the defect being 2.6 and 2.9 mm, respectively. Laparoscopy was performed. The special feature of the operation was to locate a thinned uterine scar, by using the original technique for transilluminating the scar area with a LED fiber-optic stent. This technique involved transillumination using a fiber-optic catheter connected to a light source in order to locate the area of a thinned uterine scar without the need for preliminary hysteroscopic imaging.
Conclusion. A laparoscopic approach can be considered as the procedure of choice for the repair of a large myometrial defect with residual myometrial thinning in the presence of more than one inconsistent uterine scar.
Keywords
cesarean section
uterine scar
uterine scar inconsistence
niche
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Received 03.03.2020
Accepted 29.10.2020
About the Authors
Vitaly A. Reznik, PhD, Associate Professor, Department of Obstetrics and Gynecology, Chief Physician of the Clinic, St. Petersburg State Pediatric Medical University,Ministry of Health of Russia, Saint Petersburg, Russia. E-mail: vitaliy-reznik@mail.ru. 194100, Russia, Saint Petersburg, Litovskaya str., 2.
Anna A. Malysheva, Gynecologist, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg, Russia. E-mail: annataits1@rambler.ru. 194100, Russia, Saint Petersburg, Litovskaya str., 2.
Valeriy I. Matukhin, graduate student, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg, Russia. E-mail: val-matukhin@mail.ru. ORCID: 0000-0002-8906-8356. 194100, Russia, Saint Petersburg, Litovskaya str., 2.
Nikolai N. Rukhliada, MD, PhD, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University,
Ministry of Health of Russia, Saint Petersburg, Russia. E-mail: nickolasr@ mail.ru. 194100, Russia, Saint Petersburg, Litovskaya str., 2.
Anna N. Taits, MD, PhD, Assistant Professor, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia,
Saint Petersburg, Russia. E-mail: annataits1@ rambler.ru. 194100, Russia, Saint Petersburg, Litovskaya str., 2.
For citation: Reznik V.A., Malysheva A.A., Matukhin V.I., Rukhliada N.N., Taits A.N. Original techniques for niche correction after two cesarean sections.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 2: 179-182 (in Russian)
https://dx.doi.org/10.18565/aig.2021.2.179-182
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