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Caesarean section is one of the most common surgical procedures. The multiplication of uterine scars leads to an increase in complications and in particular those related to poor healing such as isthmocele or uterine rupture.
The processes of uterine healing at the histological scale are little known. The main objective of the research is to analyze the process of uterine healing by means of uterine biopsies performed on the areas of cesarean section scars.
Our hypothesis is that there is a histological healing defect visible on an anatomopathologic examination of the scar. This poor uterine healing on histological scale is probably associated with uterine healing defects visible on pelvic ultrasound (scar dehiscence) and clinical criteria (number of caesareans, symptoms).
The objective of the research is to analyze uterine scarring by means of uterine biopsies performed on the areas of cesarean section scars. The uterine scarred areas will be analyzed histologically according to specific criteria and compared to healthy uterine areas. Histological characteristics will be compared with clinical and ultrasound data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Scarred uterus | Experimental | Patients who have already undergone one or more cesarean section(s) during a previous pregnancy and for whom a cesarean section is indicated on a scheduled or emergency basis. |
|
| Scar dehiscence surgery | Experimental | Patients who have already undergone one or more caesarean section(s) and for whom the surgical management of a dehiscence of a caesarean section scar is indicated outside of pregnancy. |
|
| Healthy uterus | Experimental | Patients with no history of caesarean section, pregnant with an indication for caesarean section: patients who have never had a caesarean section during a previous pregnancy or who are pregnant with their first pregnancy and for whom a caesarean section is indicated scheduled or urgently" |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| uterine biopsies | Procedure | uterine biopsies performed on the areas of cesarean section scars |
|
| Measure | Description | Time Frame |
|---|---|---|
| Analyze the process of uterine healing | The main objective of the research is to analyze the process of uterine healing by means of uterine biopsies performed on the areas of cesarean section scars " | 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Histological aspects of the scar | The secondary evaluation criteria will be the correlation of the histological aspects of the scar with the clinical and ultrasound data. The objective is to look for risk factors for poor uterine healing. | 8 weeks |
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Inclusion Criteria:
Group 1:
Group 2:
- Surgical management of caesarean section scar dehiscence after a caesarean section
Group 3 (control):
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Perrine CAPMAS | Contact | 0145217714 | perrine.capmas@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Perrine CAPMAS | APHP | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AP-HP, Bicêtre Hospital | Le Kremlin-Bicêtre | 94275 | France |
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Uterine biopsy and cesarean scar dehiscence
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