First trimester diagnosis and management of pregnancies implanted into the lower uterine segment
Cesarean section scar.
The incidence of a thin lower uterine segment
increased as either the number of CSs or the urgency of the procedure increased.
The lower uterine segment
, the site to be cut, becomes thinner after labor onset.
Packing of lower uterine segment
for control of post-cesarean bleeding in instances placenta previa.
Placenta previa is the partial or complete attachment of placenta in lower uterine segment
. Maternal and fetal morbidity and mortality from placenta previa is considerable and associated with high demands on health care resources.
However, considering cervical dystocia, which results in inability to attain adequate cervical dilatation, in addition to obstructive labor, as well as cervical laceration and a predisposition to rupture of the lower uterine segment
, emergency caesarean section was performed to avoid the above-mentioned intrapartum complication in Case 1.
At 21 weeks of pregnancy, she claimed vaginal bleeding, and her lower uterine segment
lengths were shortened from 23 mm to 13 mm.
Sagittal and axial T1- and T2-weighted images demonstrated a gestational sac bulging through the myometrium of the lower uterine segment
in the region of Cesarean section scar (Figure 4).
The afferent pain fibres of the cervix and lower uterine segment
are carried along with the utero-vaginal plexus to the inferior hypogastric plexus.
An urgent MRI was performed and showed a normal sized uterus with an irregular complex mass of 25 x 30 x 30 mm at the lower uterine segment
anteriorly at the previous cesarean scar site.
Women who had coagulopathy disorders, lower uterine segment
tears extending to the vagina, and bleeding due to an injured artery were excluded from the study.
The choice of balloon dilatation time and uterine incision varies according to the experience and cognition of the surgical doctor, Among the subjects, 42 cases were regarded as group A, as the abdominal aortic occlusion time was selected before the fetal delivery, the transverse incision was selected in the lower uterine segment
, and the fetus was delivered through the placenta hole.