Document Detail

The obstetrical history in patients with Pfannenstiel scar endometriomas--an analysis of 81 patients.
MedLine Citation:
PMID:  17028436     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The participation of immune tolerance during pregnancy was suggested to be an important factor predisposing to the implantation of decidual cells after cesarean section in Pfannenstiel scar. Delivery at term is related to the termination of immune tolerance to fetal antigens that is maintained throughout pregnancy. Substantial proportion of cesarean section deliveries is performed before the onset of true term labor. The aim of this study was to analyze the clinical symptoms of spontaneous beginning of labor in pregnant women in whom cesarean sections were performed and in whom Pfannenstiel scar endometriomas were observed during follow-up. MATERIALS AND METHODS: We have retrospectively analyzed 81 patients following the surgical removal of scar endometrioma after cesarean section. Obstetrical histories of cesarean sections in the number of 5,370 preceding the occurrence of the scar endometrioma were analyzed. These data were collected in six different Gynecological and Obstetrical wards in Malopolska Province in Poland. Analysis of data was started by the retrospective evaluation of regular uterine contractions, uterine cervix ripening before cesarean section and the indications for surgery. RESULTS: In 67 women from the group of 81 patients cesarean sections were performed with unripe uterine cervix and without the presence of regular uterine contractions. Elective indications for cesarean sections were predominant in this group of women. The relative risk of scar endometriomas occurrence following cesarean sections performed before onset of labor in comparison to cesarean sections following spontaneous onset of labor was statistically significantly higher [RR = 2.16, 95% CI = 1.21-3.83; OR = 2.18, 95% CI = 1.22-3.89]. CONCLUSIONS: Cesarean section performed before spontaneous onset of labor may increase substantially the risk of occurrence of scar endometriomas.
Lukasz Wicherek; Marek Klimek; Joanna Skret-Magierlo; Artur Czekierdowski; Tomasz Banas; Tadeusz J Popiela; Janusz Kraczkowski; Jerzy Sikora; Marcin Oplawski; Agata Nowak; Andrzej Skret; Antoni Basta
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-10-06
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  63     ISSN:  0378-7346     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  2007  
Date Detail:
Created Date:  2007-02-14     Completed Date:  2007-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  107-13     Citation Subset:  IM    
Department of Gynecology and Infertility, Jagiellonian University, Krakow, Poland.
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MeSH Terms
Cesarean Section / adverse effects*
Cicatrix / pathology*,  surgery
Endometriosis / etiology*
Labor Onset / physiology*
Labor, Obstetric
Retrospective Studies
Risk Factors
Uterine Contraction

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