Presentación clínica y ultrasonográfica del istmocele en pacientes con cesárea previa

Translated title of the contribution: Clinical and ultrasonographic presentation of isthmocele in patients with previous cesarean section

Luisa Fernanda López Torres, Juliana Quirós Sánchez, Luis Carlos Serna Hoyos, María Fernanda López Restrepo, Luis Guillermo Echavarría Restrepo, María Nazareth Campo Campo, Diana Paola Cuesta Castro

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Introduction: Delivery care by cesarean section is a frequent procedure in which a defect known as isthmocele can appear with frequent clinical consequences such as hemorrhage, dysmenorrhea, dyspareunia and acute and chronic pelvic pain. Objectives: To describe the clinical and ultrasonographic findings in patients with isthmocele after performing a cesarean section and the possible relationship with the grade / size of the lesion. Methods: Cross-sectional, analytical study was carried out in patients with isthmocele and a history of caesarean section evaluated from May 2016 to May 2017, in three hospitals in Medellín, Colombia. Patients with suspected gynecological cancer or with another uterine cause that explained the symptoms were excluded. Results: Twenty-six patients were analyzed, whom suffered conditions associated clinical manifestations such as chronic pelvic pain (80.8%), abnormal uterine bleeding (73.1%), pelvic infection (46.2%), and secondary infertility (15.4%). 34.6% were classified as grade I and II and the rest was classified as grade III. Other ultrasonographic findings were uterine myomatosis category 4-5 from the International Federation of Gynecology and Obstetrics (42.3%), retroverted uterus (19.2%), endometrial polyps (11.5%), ovary simple cysts (15, 4%) and endometriosis (7.7%). No association was found between the severity of the isthmocele with a previous number of cesarean sections and clinical symptoms. Conclusions: Isthmocele is a direct sequela of cesarean delivery. Clinical manifestations such as abnormal uterine bleeding, chronic pelvic pain, secondary infertility, and pelvic infection are common. There is a relationship between the severity of the isthmocele and the clinical manifestations of the disease.

    Translated title of the contributionClinical and ultrasonographic presentation of isthmocele in patients with previous cesarean section
    Original languageSpanish
    Article numbere469
    Pages (from-to)1-15
    Number of pages15
    JournalRevista Cubana de Obstetricia y Ginecologia
    Volume46
    Issue number3
    StatePublished - 2020

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