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Case Reports
. 2022 Feb 11;10(2):e05441.
doi: 10.1002/ccr3.5441. eCollection 2022 Feb.

Early identification of uterine scar defect by preconception magnetic resonance imaging to achieve successful pregnancy outcome after laparoscopic-assisted myomectomy: Two case reports

Akihiro Takeda  1 , Mayu Shibata  1 , Wataru Koike  2
Affiliations
Case Reports

Early identification of uterine scar defect by preconception magnetic resonance imaging to achieve successful pregnancy outcome after laparoscopic-assisted myomectomy: Two case reports

Akihiro Takeda et al. Clin Case Rep. .

Abstract

Myomectomy improves the reproductive ability of women. However, the risk for uterine rupture and abnormal placentation remains a concern. In two cases with scar defects after laparoscopic-assisted myomectomy, one case developed amniocele, while other case showed abnormally invasive placenta. Obstetrical management measures with cesarean sections yielded uneventful postoperative courses.

Keywords: laparoscopic‐assisted myomectomy; magnetic resonance imaging; myomectomy scar defect; preconception management; pregnancy outcomes.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

FIGURE 1
FIGURE 1
A case showing amniocele at the site of scar defect in pregnancy after laparoscopic‐assisted myomectomy. (A) Sagittal T2‐weighted magnetic resonance imaging (MRI) showed multiple intra‐myometrial and subserosal myomas at the initial examination. (B) Sagittal T2‐weighted MRI showed myomectomy scar thinning (arrow) at the fundal portion three months after LAM. (C) Sagittal T2‐weighted MRI showed extreme myomectomy scar thinning with partial dehiscence (arrow) and low‐lying placenta (arrowhead). (D) Sagittal T2‐weighted MRI showed the formation of an asymptomatic amniocele (arrow) with an intact uterine serosa at 24 weeks of gestation. (E) Coronal T2‐weighted MRI showed that the right hand of the fetus entered the enlarged amniocele at 31 weeks of gestation. (F) A thinned myomectomy scar (arrow) is shown at 34 weeks of gestation, elective cesarean section was performed
FIGURE 2
FIGURE 2
A case showing placenta increta at the site of scar defect in pregnancy after laparoscopic‐assisted myomectomy. (A) Sagittal T2‐weighted magnetic resonance imaging (MRI) showed multiple intra‐myometrial myomas at the initial examination. (B) Sagittal T2‐weighted MRI showing myomectomy scar thinning (arrow) at the fundal portion, three months after LAM. (C) Sagittal T2‐weighted MRI showing placenta increta (arrowhead) at the site of the thinned myomectomy scar and placenta previa (arrowhead) at 14 weeks of gestation
See this image and copyright information in PMC

References

    1. Falcone T, Parker WH. Surgical management of leiomyomas for fertility or uterine preservation. Obstet Gynecol. 2013;121(4):856‐868. - PubMed
    1. Gyamfi‐Bannerman C, Gilbert S, Landon MB, et al. Risk of uterine rupture and placenta accreta with prior uterine surgery outside of the lower segment. Obstet Gynecol. 2012;120(6):1332‐1337. - PMC - PubMed
    1. Seracchioli R, Manuzzi L, Vianello F, et al. Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertil Steril. 2006;86(1):159‐165. - PubMed
    1. Koo YJ, Lee JK, Lee YK, et al. Pregnancy outcomes and risk factors for uterine rupture after laparoscopic myomectomy: a single‐center experience and literature review. J Minim Invasive Gynecol. 2015;22(6):1022‐1028. - PubMed
    1. Warshak CR, Eskander R, Hull AD, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol. 2006;108(3):573‐581. - PubMed

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