重新评估剖腹产疤痕缺陷的变化。

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Journal of Obstetrics and Gynaecology Research Pub Date : 2024-11-05 DOI:10.1111/jog.16137
Hiroshi Kobayashi, Shogo Imanaka
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引用次数: 0

摘要

目的:随着剖宫产率的增加,剖宫产瘢痕缺损(CSD)的发病率也越来越高,主要表现为受影响的妇女经后出血。CSD 的表现形式多种多样,包括孤立的子宫肌层缺损、宫腔内囊性突起和宫腔外囊性延伸。人们对 CSD 及其相关症状的病理生理机制仍不甚了解。这篇综述探讨了 CSD 的发病机制,强调了其形态学特征,重点是其临床多样性,并探讨了未来研究面临的挑战:方法:使用PubMed和谷歌学术等电子数据库进行了全面的叙述性综述,以确定截至2023年12月31日发表的41篇相关文献:子宫肌层由两层不同的肌层组成--子宫肌内层和子宫肌外层,它们的起源、结构和功能各不相同。这两层子宫肌层的破坏会导致 CSD 的发生。从组织病理学角度看,有症状的CSD可能与子宫瘢痕子宫内膜异位症、囊性子宫腺肌病或子宫内膜囊肿有关,这表明CSD,尤其是那些需要手术干预的CSD,并不局限于子宫肌层缺陷,还可能涉及先天性子宫内膜异位症或子宫腺肌病,从而加重临床症状:本综述提供了对 CSD 组织病理学特征和分类的最新理解,重点在于阐明其潜在的发病机制。
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Reevaluating the variation of cesarean scar defect.

Aim: The increasing incidence of cesarean sections has led to a higher prevalence of cesarean scar defects (CSDs), predominantly characterized by postmenstrual bleeding in affected women. CSD manifests in various forms, including isolated myometrial defects, intrauterine cystic protrusions, and extrauterine cystic extensions. The pathophysiological mechanisms underpinning CSD and its associated symptoms remain insufficiently understood. This review explores the pathogenesis of CSD, highlights its morphological characteristics with an emphasis on variable clinical diversity, and addresses the challenges for future research.

Methods: A comprehensive narrative review was conducted using electronic databases, including PubMed and Google Scholar, to identify 41 relevant literatures published up to December 31, 2023.

Results: The myometrium comprises two distinct layers-the inner and outer myometrium-with differences in their origin, structure, and function. Disruptions within these layers contribute to CSD development. Histopathologically, symptomatic CSD may be linked to uterine scar endometriosis, cystic adenomyosis, or endometrial cysts, suggesting that CSD, particularly those necessitating surgical intervention, are not limited to myometrial defects but may also involve iatrogenic endometriosis or adenomyosis, thereby exacerbating clinical symptoms.

Conclusion: This review provides an updated understanding of the histopathological features and classification of CSD, with an emphasis on elucidating its underlying pathogenesis.

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
376
审稿时长
3-6 weeks
期刊介绍: The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.
期刊最新文献
Association of maternal 25(OH)D levels during pregnancy with fetal birth weight and preschooler growth status: A retrospective birth cohort study. Comparison of outcomes of labor induction with dinoprostone vaginal insert (PROPESS) and double balloon cook catheter in term nulliparous pregnancies. Malignant peripheral nerve sheath tumor of the cervix in an adolescent with neurofibromatosis type 1: A case report and review of literature. Reevaluating the variation of cesarean scar defect. Clinical implications of genetic testing for congenital protein C deficiency in pregnancy.
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