中国实用妇科与产科杂志

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经阴道剖宫产切口瘢痕缺损修补手术临床结局

  

  1. 中国医学科学院北京协和医院妇产科,北京 100730
  • 出版日期:2021-07-02 发布日期:2021-07-22
  • 通讯作者: 朱兰
  • 基金资助:
    国家自然科学基金重点项目(81830043)

Clinical outcomes of a transvaginal repair for cesarean scar defect.

  1. Department of Obstetrics & Gynecology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China
  • Online:2021-07-02 Published:2021-07-22

摘要: 剖宫产切口瘢痕缺损(cesarean scar defect,CSD)形成的肌层缺陷可能导致月经出血时间延长的症状,甚至影响下次妊娠。文章阐述了8项经阴道CSD修补手术后阴道流血、肌层厚度的变化,以及对后续妊娠影响的研究。其中3项研究还对比了经阴道手术和腹腔镜、宫腔镜修补方式的临床结局。整体上经阴道修补手术能够显著增厚剩余肌层厚度和缩短月经时间,同时节约经济花费和手术时间,可作为修补CSD的重要手术方法。

关键词: 剖宫产切口瘢痕缺损, 经阴道修补, 月经延长, 剩余肌层厚度

Abstract: China bears a great cesarean rate, therefore,many women with cesarean scar defect suffers from spotting symptoms or even threatened pregnant potential. This review aims to evaluate whether the transvaginal repair of the defect is effective in correcting post-menstruation bleeding,myometrial thickness and obstetric outcome. We summarized all 8 retrospective cohort studies and evaluation of post-operation follow-up.Three studies compared Transvaginal approach from laparoscopic or hysteroscopic repair of the defect. The mean thickness of the myometrium increased and the menses duration significantly shortened in the majority. For symptomatic women,transvaginal repairmen of cesarean scar defect could be considered an appropriate approach,which is much more economical and time-saving.

Key words: cesarean scar defect, transvaginal repair, prolonged menstruation, thickness of remaining muscular layer

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