In the first-ever case in India, a woman delivered a child post-correction surgery of caesarean scar defect. The defect or isthmocele is an under-diagnosed cause of infertility which causes due to the presence of a cavity at the site of the caesarean delivery scar. The defect has been surgically treated before but this is the first case of a successful pregnancy after surgery, shared doctors.
Neetu Kumari, 38, had a difficulty conceiving eight years back, which resulted in a caesarean delivery after abnormal delivery. She was then medically treated for hormonal imbalance despite also suffering from a decreased ovarian reserve. She was treated for the defect and thus was able to deliver a full-term girl child.
"Caesarean section is an inevitable and beneficial operation in many high-risk cases of pregnancy, however at the same time, there may be potential side effects. Uterine scar insufficiency/isthmocele is diagnosed in one percent of women who have undergone a caesarean section. It is a defect of a previous caesarean scar due to poor healing after surgery. Several obstetric complications due to inappropriately healed caesarean scar such as placenta accreta, scar dehiscence, and ectopic scar pregnancy are increasingly reported along with rising caesarean rates. It may also cause a rupture in advanced pregnancy," said Dr Aradhana Kalra, Senior Consultant, Milann Fertility Center, Delhi.
Kumari had also undergone laparoscopy earlier as well but the diagnosis got missed. "In all the cases that we received, the diagnosis was missed earlier during serial ultrasounds and even laparoscopy. Given the absence of a clearly defined surgical method in the literature, choosing the proper approach to treating isthmocele can be arduous. Laparoscopy provides a minimally invasive procedure in women with previous caesarean scar defects and improves the chances of conception," added Kalra.
There have been case reports of pregnancy and delivery after C-section defect repair from countries like Europe and Russia, but this is the first case of successful conception and delivery after isthmocele repair.
INFERTILE PHASE IS OVER
- Neetu Kumari, 38, had a difficulty conceiving eight years back
- She then conceived and delivered a baby girl through caesarean
- During that delivery she suffered a scar and which made her infertile
- It was difficult for doctors to detect what was the major reason for infertility
- Last year, doctor detected the scar and she underwent for scar treatment aand managed to conceive again
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