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Clinical outcomes of hysteroscopy‐assisted transvaginal repair of cesarean scar defect
Author(s) -
Zhou Dan,
Wu Fengli,
Zhang Qiao,
Cui Ying,
Huang Shuai,
Lv Qiubo
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14161
Subject(s) - medicine , hysteroscopy , surgery , perioperative , laparotomy , blood loss
Aim This study was conducted to evaluate comparative clinical outcomes of hysteroscopy‐assisted transvaginal repair in the treatment of cesarean scar defect (CSD) in patients desirous of conceiving again. Methods We retrospectively enrolled 63 patients with CSD who were treated at Beijing Hospital between January 2014 and January 2016. Patients were divided into the hysteroscopic electrocauterization group (electrocauterization group, n = 28) and hysteroscopy‐assisted transvaginal repair group (transvaginal group, n = 35). Perioperative parameters including operation time, intraoperative blood loss, time to passage of flatus, hospitalization duration, duration of postoperative vaginal bleeding, pre‐ and postoperative myometrial thickness, rate of full‐term births and surgical complications were compared between the two groups. Results At the 6‐month follow‐up, myometrial thickness was significantly greater in the transvaginal group (9.8 ± 1.0 mm) compared to the electrocauterization group (3.3 ± 0.7 mm, P < 0.05). One patient in the transvaginal group required intraoperative conversion to laparotomy because of surgical complications. The transvaginal group had a significantly higher rate of full‐term live birth compared to the electrocauterization group (92% vs 46%, P < 0.05). There were no significant between‐group differences in the other pre‐, intra‐, and postoperative parameters. The maximum postoperative diameter of the CSD in the transvaginal and electrocauterization groups was 1.6 ± 0.8 and 17 ± 2.0 mm, respectively. Conclusion Compared to hysteroscopic electrocauterization, hysteroscopy‐assisted transvaginal repair of CSD was associated with better clinical outcomes and higher rate of full‐term live births.