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Uterine deformity caused by surgery during pregnancy
S Kawakami1, K Togashi, T Sagoh
1Department of Radiology and Nuclear Medicine, Kyoto University, Faculty of Medicine, Japan.
Objective:
The purpose of our study was to determine the cause of a unique deformity of the uterus, in which the cervix is elongated and appears fixed to the anterior abdominal wall.
Materials And Methods:
Imaging from 2,558 consecutive MR studies of the pelvis of women were retrospectively reviewed for the simultaneous presence of elongation of the uterine cervix, angulation of the uterine isthmus just beneath the anterior abdominal wall, and vertical orientation of the long axis of the uterine corpus.
Results:
Fourteen cases exhibited the uterine deformity; 13 of these cases had histories of cesarean section (CS) performed from 9 to 33 years (mean 18.2 years) previous to MRI. Among them, six patients had a history of multiple CS. The remaining case had a history of enucleation at 13 weeks' gestation of uterine leiomyoma, located at the anterior wall of the lower uterine segment. Thirteen patients had not become pregnant after the last CS (no. = 12) or the myomectomy (no. = 1).
Conclusion:
This unique uterine deformity strongly indicates a history of incision in the lower uterine segment especially at late gestational age. Since all but one patient with this deformity did not become pregnant after the last surgery, this deformity may be one reason for infertility after CS.