Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect
Cesarean scar defect, niche or isthmocele represents a poor healing in the anterior uterine wall after performing a cesarean section. The cesarean scar defect can be asymptomatic, or the patient could present abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia, cesarean scar pr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2021-12-01
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| Series: | Romanian Medical Journal |
| Subjects: | |
| Online Access: | https://rmj.com.ro/articles/2021.4/RMJ_2021_4_Art-08.pdf |
| _version_ | 1797329574330105856 |
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| author | Roxana-Elena Bohiltea Bianca-Margareta Mihai Valentin Varlas Vlad Dima Tiberiu Augustin Georgescu Emilia-Maria Vladareanu Nicolae Bacalbasa Corina Grigoriu |
| author_facet | Roxana-Elena Bohiltea Bianca-Margareta Mihai Valentin Varlas Vlad Dima Tiberiu Augustin Georgescu Emilia-Maria Vladareanu Nicolae Bacalbasa Corina Grigoriu |
| author_sort | Roxana-Elena Bohiltea |
| collection | DOAJ |
| description | Cesarean scar defect, niche or isthmocele represents a poor healing in the anterior uterine wall after performing a cesarean section. The cesarean scar defect can be asymptomatic, or the patient could present abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia, cesarean scar pregnancy or abnormal placenta. Abnormal uterine bleeding caused by cesarean scar defect presents as a postmenstrual spotting and has become more and more common among women with a history of minimum one cesarean section delivery. The most studied risk factors are: multiple cesarean section deliveries, single layer suture, locked suture, retroflexed uterus and cesarean section delivery performed during active labor with a cervical dilatation of 5 cm. There have been described several surgical approaches: hysteroscopic, laparoscopic or vaginal. From our experience, we have treated successfully symptomatic patients with cesarean scar defect with the levonorgestrel-releasing intrauterine system. Although the therapeutic indications do not include this specific use, we have obtained significant improvement of abnormal uterine bleeding due to cesarean scar defect in our patients. Our results sustain the necessity of extensive interventional studies. |
| first_indexed | 2024-03-08T07:06:35Z |
| format | Article |
| id | doaj.art-47d12914471c404dbafe471fbc206049 |
| institution | Directory Open Access Journal |
| issn | 1220-5478 2069-606X |
| language | English |
| last_indexed | 2024-03-08T07:06:35Z |
| publishDate | 2021-12-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Medical Journal |
| spelling | doaj.art-47d12914471c404dbafe471fbc2060492024-02-03T04:17:19ZengAmaltea Medical Publishing HouseRomanian Medical Journal1220-54782069-606X2021-12-0168446146410.37897/RMJ.2021.4.8Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defectRoxana-Elena Bohiltea0Bianca-Margareta Mihai1Valentin Varlas2Vlad Dima3Tiberiu Augustin Georgescu4Emilia-Maria Vladareanu5Nicolae Bacalbasa6Corina Grigoriu7Department of Obstetrics and Gynecology, “Carol Davila“ University of Medicine and Pharmacy, Bucharest, RomaniaFilantropia Clinical Hospital, Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; Filantropia Clinical Hospital, Bucharest, RomaniaFilantropia Clinical Hospital, Bucharest, RomaniaDepartment of Pathology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “Alessandrescu-Rusescu” National Institute for Mother and Child Health, BucharestFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila“ University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, RomaniaCesarean scar defect, niche or isthmocele represents a poor healing in the anterior uterine wall after performing a cesarean section. The cesarean scar defect can be asymptomatic, or the patient could present abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia, cesarean scar pregnancy or abnormal placenta. Abnormal uterine bleeding caused by cesarean scar defect presents as a postmenstrual spotting and has become more and more common among women with a history of minimum one cesarean section delivery. The most studied risk factors are: multiple cesarean section deliveries, single layer suture, locked suture, retroflexed uterus and cesarean section delivery performed during active labor with a cervical dilatation of 5 cm. There have been described several surgical approaches: hysteroscopic, laparoscopic or vaginal. From our experience, we have treated successfully symptomatic patients with cesarean scar defect with the levonorgestrel-releasing intrauterine system. Although the therapeutic indications do not include this specific use, we have obtained significant improvement of abnormal uterine bleeding due to cesarean scar defect in our patients. Our results sustain the necessity of extensive interventional studies.https://rmj.com.ro/articles/2021.4/RMJ_2021_4_Art-08.pdfcesarean scar defectisthmocelelevonorgestrelpostmenstrual spottingnicheabnormal uterine bleeding |
| spellingShingle | Roxana-Elena Bohiltea Bianca-Margareta Mihai Valentin Varlas Vlad Dima Tiberiu Augustin Georgescu Emilia-Maria Vladareanu Nicolae Bacalbasa Corina Grigoriu Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect Romanian Medical Journal cesarean scar defect isthmocele levonorgestrel postmenstrual spotting niche abnormal uterine bleeding |
| title | Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect |
| title_full | Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect |
| title_fullStr | Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect |
| title_full_unstemmed | Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect |
| title_short | Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect |
| title_sort | levonorgestrel intrauterine device as a non invasive approach of abnormal uterine bleeding caused by cesarean scar defect |
| topic | cesarean scar defect isthmocele levonorgestrel postmenstrual spotting niche abnormal uterine bleeding |
| url | https://rmj.com.ro/articles/2021.4/RMJ_2021_4_Art-08.pdf |
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