title: Implantation despite an extensive endometrial defect after hysteroscopic resection of symptom-free residual trophoblastic tissue 15 months after cesarean section.
abstract: Successful implantation occurred after embryo transfer in the presence of an extensive endometrial defect after hysteroscopic resection of residual trophoblastic tissue 15 months after cesarean section. At the end of hysteroscopic surgery the anterior uterine wall seemed smooth, although ultimately no endometrium was left in that part and in parts of the fundus. Thus implantation is possible even with extensive endometrial defects. Interesting facts in this case were, first, the long symptom-free period with residual trophoblastic tissue in the uterus, and, second, successful implantation, pregnancy, and delivery despite at least 30% of endometrial surface being irreversibly destroyed. We suggest hysteroscopic resection as the method of choice for exact and minimally traumatic removal of especially older residual trophoblastic tissue.
authors.affiliation: Department of Obstetrics and Gynecology, University of Cologne, Kerpener Strasse 34, 50931 Cologne, Germany.
authors.forename: Dolores
authors.initials: D
authors.lastname: Foth
authors.forename: Frank
authors.initials: F
authors.lastname: Nawroth
authors.forename: Eugenia
authors.initials: E
authors.lastname: Isachenko
authors.forename: Markus
authors.initials: M
authors.lastname: Valter
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
authors.forename: Torsten
authors.initials: T
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D010064:Embryo Implantation; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors; D014327:Trophoblasts / Q000000981:diagnostic imaging