Open AccessHistopathological evaluation of cesarean scar defect in women with cesarean scar syndrome
Author(s) -
Higuchi Asuka,
Tsuji Shunichiro,
Nobuta Yuri,
Nakamura Akiko,
Katsura Daisuke,
Amano Tsukuru,
Kimura Fuminori,
Tanimura Satoshi,
Murakami Takashi
Publication year - 2021
Publication title -
reproductive medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.005
H-Index - 22
eISSN - 1447-0578
pISSN - 1445-5781
DOI - 10.1002/rmb2.12431
Subject(s) - medicine , adenomyosis , h&e stain , hysterectomy , infertility , cd68 , endometriosis , gynecology , recurrent miscarriage , lesion , cd20 , endometrium , immunohistochemistry , surgery , pregnancy , obstetrics , pathology , miscarriage , biology , genetics
Purpose To explore the histopathological findings of cesarean scar defect (CSD) and the immunological component in women with cesarean scar syndrome (CSS). Methods This retrospective study was conducted in a university hospital and a public hospital. A total of 63 patients with secondary infertility due to CSS who underwent laparoscopic resection of the CSD lesion were enrolled (CSS group), and 21 patients who underwent hysterectomy with a history of cesarean section were enrolled as control (non‐CSS group). We compared the differences in histopathological findings of CSD lesions by hematoxylin and eosin staining and immunohistochemistry for CD3, CD20, CD56, CD68, CD138, myeloperoxidase, and tryptase between the two groups. Results The frequency of presence of endometrium on the CSD surface was significantly lower ( p = 0.0023) and that of adenomyosis was significantly higher ( p = 0.0195) in the CSS group than in the non‐CSS group. The number of CD3‐, CD20‐, CD68‐, and tryptase‐positive cells was significantly lower in the CSS group than in the non‐CSS group; however, the number of CD138‐positive cells was significantly higher in the CSS group ( p = 0.0042). Conclusions This study suggested that the absence of endometrium, presence of adenomyosis, and chronic inflammation in CSD contributes to secondary infertility due to CSS.