{"title":"重新评估剖腹产疤痕缺陷的变化。","authors":"Hiroshi Kobayashi, Shogo Imanaka","doi":"10.1111/jog.16137","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>This review provides an updated understanding of the histopathological features and classification of CSD, with an emphasis on elucidating its underlying pathogenesis.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reevaluating the variation of cesarean scar defect.\",\"authors\":\"Hiroshi Kobayashi, Shogo Imanaka\",\"doi\":\"10.1111/jog.16137\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>This review provides an updated understanding of the histopathological features and classification of CSD, with an emphasis on elucidating its underlying pathogenesis.</p>\",\"PeriodicalId\":16593,\"journal\":{\"name\":\"Journal of Obstetrics and Gynaecology Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Obstetrics and Gynaecology Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jog.16137\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynaecology Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jog.16137","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
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.
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.