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Case 47 - A 33-Year-Old G2P2 Woman with Persistent Irregular Vaginal Bleeding after Cesarean Delivery

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 33-year-old female, gravida 2, para 2, presents with irregular intermenstrual bleeding occurring each month since undergoing her second cesarean delivery 15 months ago. Since finishing breastfeeding, she has experienced light intermenstrual bleeding episodes following menses. She denies any change in bowel or bladder symptoms. She is sexually active with one partner using condoms and denies pain or bleeding with intercourse. She denies any history of sexually transmitted diseases or abnormal Pap test that required treatment. Her past medical and surgical histories are non-contributory. She is not taking any medications and denies medication allergy.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 143 - 145
Publisher: Cambridge University Press
Print publication year: 2021

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References

Morris, H. Surgical pathology of the lower uterine segment cesarean section scar: is the scar the source of clinical symptoms? Int J Gynecol Pathol 1995; 14(1): 1620.CrossRefGoogle ScholarPubMed
Antila-Långsjö, RA, Mäenpää, JU, Huhtala, HS, et al. Cesarean scar defect: a prospective study on risk factors. Am J Obstet Gynecol 2018; 219: 458.e18.CrossRefGoogle ScholarPubMed
Luo, L, Niu, G, Wang, Q, et al. Vaginal repair of cesarean section scar diverticula. J Minim Invasiv Gynecol 2012; 19: 454–8.CrossRefGoogle ScholarPubMed
Tower, AM, Frishman, GN. Cesarean scar defects: an under-recognized cause of abnormal uterine bleeding and other gynecologic complications. J Minim Invasive Gynecol 2010; 20: 562–72.Google Scholar
Florio, P, Filippeschi, M, Moncini, I, et al. Hysteroscopic treatment of the cesarean-induced isthmocele in restoring fertility. Curr Opin Obstet Gynecol 2012; 24: 180–6.CrossRefGoogle Scholar
Sipahi, S, Sasaki, K, Miller, CE. The minimally invasive approach to the symptomatic isthmocele - what does the literature say? A step-by-step primer on laparoscopic isthmocele - excision and repair. Curr Opin Obstet Gynecol 2017; 29: 257–65.CrossRefGoogle Scholar
He, Y, Zhong, J, Zhou, W, et al. Four surgical strategies for the treatment of cesarean scar defect: a systematic review and network meta-analysis. J Minim Invasive Gynecol 2020; 27: 593602.CrossRefGoogle ScholarPubMed
Vitale, SG, Ludwin, A, Vilos, GA, et al. From hysteroscopy to laparoendoscopic surgery: what is the best surgical approach for symptomatic isthmocele? A systematic review and meta-analysis. Arch Gynecol Obstet 2020; 301(1): 3352.CrossRefGoogle ScholarPubMed

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