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02 July 2021, Volume 37 Issue 7 Previous Issue    Next Issue

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Non-operative treatment for abnormal vaginal bleeding due to scar defect of incision in cesarean section. SONG Jian-dong，SA Ri-na 2021, 37(7): 702-705.  DOI: 10.19538/j.fk2021070103 Abstract ( )   The most common clinical manifestation of CSD is abnormal vaginal bleeding，and there is no unified standard for its treatment. The common non-surgical treatment for CSD mainly includes oral contraceptives，levonorgestrel intrauterine contraceptive system，traditional Chinese medicine treatment and combined traditional Chinese and Western medicine treatment，but the related research is very limited，which needs further practice and research；so the treatment needs individualized choice.

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Controversy on surgical techniques and incision healing of cesarean section. ZHENG Xiu-hui，LI Li 2021, 37(7): 705-707.  DOI: 10.19538/j.fk2021070104 Abstract ( )   Cesarean section technology has become one of the main means to deal with obstetric emergencies. Surgical skills of cesarean section is of great significance to improve the prognosis of surgery. This article discusses the disputes on cesarean section skills which affect the healing of uterine incision，and discusses the relationship between operative skills and wound healing from the aspects of operative selsction technique，operative method，suturing method and suture choice.

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A new surgery mode to treat CSD based on pathological changes. MAO Meng，GUO Rui-xia 2021, 37(7): 707-710.  DOI: 10.19538/j.fk2021070105 Abstract ( )   Currently, the surgical treatment for cesarean scar defect（CSD）is still unsatisfactory.In the department of Gynecology，the First Affiliated Hospital of Zhengzhou University，based on the pathological changes of CSD：diverticulum formation caused by myometrial discontinuity or defect and the secondary changes of the lining inner surface of diverticulum in the form of inflammatory reaction，congestion, atypical vessel formation and polyp，the laparoscopy-combined hysteroscopy surgical approach was adopted to correct not only the anatomical changes but also the secondary changes. In the surgery the diverticulum wasn't cut open；therefore，the abnormal uterine bleeding symptom can be effectively relieved.Our operative strategy has the advantages of less trauma and faster recovery. In addition，it is more suitable for patients who desire to become pregnant soon after surgery.It's recommended that this approach be used to treat CSD as a new standard surgery.

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Selection of surgery modes in scar defect of incision in cesarean cection. YANG Ping，XU Xiao-han 2021, 37(7): 711-713.  DOI: 10.19538/j.fk2021070106 Abstract ( )   There is no international unified definition or treatment for patients with previous cesarean scar defect（CSD）. For patients with severe symptoms and fertility requirements who didn't respond to conservative drug treatment, surgical treatment can be selected if there is a desire for surgery. The four main operation routes are transvaginal, hysteroscopic，laparoscopic and laparoscopic combined with hysteroscopic. Each of these methods has its own advantages and disadvantages，and the surgeons should make an individualized treatment plan according to the clinical symptoms of the patients，the size and location of the diverticulum，the surgical conditions in the hospital and the surgical skills of the operators.

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Clinical outcomes of a transvaginal repair for cesarean scar defect. ZHANG Duo-duo， ZHU Lan 2021, 37(7): 713-717.  DOI: 10.19538/j.fk2021070107 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.

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Pregnancy risk assessment and prevention of cesarean scar defect. HA Chun-fang，LI Yong-mei 2021, 37(7): 717-719.  DOI: 10.19538/j.fk2021070108 Abstract ( )   Cesarean scar diverticulum（CSD）is one of the long-term complications after cesarean section. The clinical common symptoms are irregular vaginal bleeding，infertility，pelvic pain and other symptoms.The obstetric risks in re-pregnancy also concern the clinicians.This paper focuses on the classification of CSD，the assessment of reproduction risk and re-pregnancy of CSD，the prevention and related pregnancy risk of CSD，by combination with an expert consensus on the diagnosis and treatment of CSD in China in 2019. Our goal is to explore the classification, grading，re-pregnancy risk，reproductive analysis and prevention of CSD，so as to provide basis for clinical evaluation and treatment of this kind of disease.