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Scar Tissue after a Cesarean Section—The Management of Different Complications in Pregnant Women

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  • Aleksandra Stupak

    (Department of Obstetrics and Pathology of Pregnancy, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin, 20-081 Lublin, Poland)

  • Adrianna Kondracka

    (Department of Obstetrics and Pathology of Pregnancy, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin, 20-081 Lublin, Poland)

  • Agnieszka Fronczek

    (Department of Pathomorphology, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin, 20-081 Lublin, Poland)

  • Anna Kwaśniewska

    (Department of Obstetrics and Pathology of Pregnancy, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin, 20-081 Lublin, Poland)

Abstract

The definition of a cesarean scar pregnancy (CSP) is the localization of the gestational sac (GS) in the cicatrix tissue, which is created in the front wall of the uterus after a previous cesarean section (CS). The worldwide prevalence of CSP has been growing rapidly. However, there are no general recommendations regarding prophylaxis and treatment of the abnormalities of the anterior wall of the uterus discovered in a non-pregnant myometrium, or how to deal with existing cases of CSP. We present the latest knowledge, a holistic approach to the biology, histology, imaging, and management concerning post-CS scars based on our cases, which were treated in the Department of Pregnancy and Pathology of Pregnancy in the Medical University of Lublin, Poland. In our study, we present images of tissue samples of areas with a cicatrix in the uterus, and ultrasound and MRI images of CSP. We discuss the advances in the biology of the post-CS scar tissue, the prevention techniques used to repair the scar defect (niche) before the pregnancy, and the treatment of different complications of CSP, such as the rupture of the gravid uterus or the dehiscence of the myometrium.

Suggested Citation

  • Aleksandra Stupak & Adrianna Kondracka & Agnieszka Fronczek & Anna Kwaśniewska, 2021. "Scar Tissue after a Cesarean Section—The Management of Different Complications in Pregnant Women," IJERPH, MDPI, vol. 18(22), pages 1-13, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:11998-:d:679711
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    References listed on IDEAS

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    1. Fabiana Cecchini & Alice Tassi & Ambrogio P. Londero & Giovanni Baccarini & Lorenza Driul & Serena Xodo, 2020. "First Trimester Uterine Rupture: A Case Report and Literature Review," IJERPH, MDPI, vol. 17(8), pages 1-13, April.
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