Isthmocele: From Risk Factors to Management

Revista Brasileira De Ginecologia E Obstetricia : Revista Da Federacao Brasileira Das Sociedades De Ginecologia E Obstetricia, 41(1), 44-52

DOI 10.1055/s-0038-1676109 PMID 30646424

Abstract

Objective

The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within the myometrium at the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition.

Methods

A comprehensive review of the literature was performed to identify the most relevant studies about this topic.

Results

Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data.

Conclusion

Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.

Topics

isthmocele cesarean scar defect comprehensive review pathophysiology classification, cesarean section niche hypoechoic myometrium uterine scar transvaginal ultrasound, isthmocele prevalence 24-70 percent sonohysterography saline infusion diagnosis, residual myometrial thickness surgical decision laparoscopic hysteroscopic repair, abnormal uterine bleeding postmenstrual spotting chronic pelvic pain isthmocele symptoms, single-layer versus double-layer uterine closure cesarean scar defect risk factors, Iannone Scutiero isthmocele management review Revista Brasileira 2019, cesarean scar ectopic pregnancy uterine rupture placenta accreta complications, cervical dilation labor duration uterine incision site healing risk factors, isthmocele medical treatment hormonal therapy oral contraceptive progesterone spotting
PMID 30646424 30646424 DOI 10.1055/s-0038-1676109 10.1055/s-0038-1676109

Cite this article

Iannone, P., Nencini, G., Bonaccorsi, G., Martinello, R., Pontrelli, G., Scioscia, M., Nappi, L., Greco, P., & Scutiero, G. (2019). Isthmocele: From Risk Factors to Management. *Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia*, *41*(1), 44-52. https://doi.org/10.1055/s-0038-1676109

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