Hysteroscopic evaluation of the cervix and uterine cavity after Cervical Advancement in cases of placenta accreta spectrum (intrventional study)

Abd Elhameed, Mohamed Salah; Elkhateeb, Reham; Abd El Zaher, Mohamed Hassan; Abd Elmaged, Ayman Nady

doi:10.21608/mjmr.2024.259914.1595

Hysteroscopic evaluation of the cervix and uterine cavity after Cervical Advancement in cases of placenta accreta spectrum (intrventional study)

Document Type : Original Article

Authors

¹ Department of obstetrics &amp; Gynecology, Faculty of Medicine, Minia University, Egypt

² Obstetrics and Gynecology, Faculty of medicine, Minia university

³ Obstetrics and Gynecology Department, Faculty of Medicine, Minia University, Minia, Egypt

⁴ obstetrics and gynecology department, faculty of medicine, minia university

10.21608/mjmr.2024.259914.1595

Abstract

Abstract

Background: Placenta accreta spectrum (PAS) diseases are primarily linked to a prior cesarean section (CS) in medical history. The objective of this study was to assess the cervix, uterine cavity for the existence of postoperative sequelae in cases of PAS following cervical advancement using a hysteroscope.

Methods: This interventional study was carried out on 43 patients aged from 19 to 39 years old, female, with history of Cervical Advancement of placenta accreta (either symptomatic or not) and females seeks fertility. Ultrasonography and hysteroscopy are assessed to all patients.

Results: There was a significant inverse relationship between the development of cervical stenosis and scar thickness, whereas There was a strong inverse relationship between cervical stenosis and the thickness of the endometrium. A strong positive correlation was seen between the development of irregularities in the uterine cavity and the thickness of the endometrium, whereas a negative correlation was found with scar thickness. There was a strong negative correlation seen between the occurrence of scar niche and cervical length, although no significant association was found with other factors.

Conclusions: The three most discovered abnormalities cervical stenosis, uterine cavity irregularity, and intrauterine adhesions are linked to cervical advancement. Some factors are correlated with ultrasound (US) findings including scar thickness, endometrial thickness, cervical length with uterine adhesions, uterine cavity irregularities and scar niche.

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