title: Radiofrequency endometrial ablation in patients with a history of low transverse cesarean delivery.
abstract: OBJECTIVE
  To assess adverse events associated with radiofrequency endometrial ablation in treatment of heavy menstrual bleeding in patients with a history of low transverse cesarean delivery (C-section group) and patients who delivered vaginally (vaginal delivery group).
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Community-based gynecology practice in the United States.
  
  
  METHODS
  The study included 194 patients (100 in the C-section group and 94 in the vaginal delivery group), aged 21 to 55 years, with a history of heavy menstrual bleeding.
  
  
  METHODS
  NovaSure endometrial ablation procedures were performed from April 2004 through December 2010.
  
  
  RESULTS
  Demographic characteristics, gynecologic and pregnancy history, and procedure setting were compared between groups. Intraoperative and postoperative adverse events that occurred within 72 hours of the procedure were summarized. The C-section and vaginal delivery groups were similar for demographic characteristics with the exception of age (mean [SD], 40.6 [5.0] years vs 42.5 [5.3] years, respectively; p = .01). Parity was significantly higher in the C-section group compared with the vaginal delivery group (2.4 [0.9] vs 2.1 [0.7]; p = .006). Adverse events commonly associated with endometrial ablation occurred in 3 patients in the C-section group and 5 patients in the vaginal delivery group (p = .68). In addition, 1 patient failed the pre-ablation cavity integrity assessment; therefore, ablation was not performed. All events resolved without sequelae. No uterine perforation or bowel or bladder injury occurred in any patient.
  
  
  CONCLUSIONS
  Radiofrequency endometrial ablation performed in a community practice was well tolerated in patients with a history of low transverse cesarean delivery.
authors.affiliation: Tennessee Women's Care, Nashville, Tennessee (all authors). Electronic address: rtadkins@comcast.net.
authors.forename: Royce T
authors.initials: RT
authors.lastname: Adkins
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Bressman
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Bressman
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Lucas
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D002585:Cesarean Section; D055356:Endometrial Ablation Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Cesarean section; Endometrial ablation; NovaSure