Pregnancy following laparoscopic hysteropexy—a case series

Pregnancy following laparoscopic hysteropexy—a case series Background: Uterine-preserving prolapse surgery offers the chance to retain fertility; however, limited data is available for the safety of pregnancy following surgery and the effect of pregnancy on surgical outcome. Our operative technique involves mesh encircling the cervix and uterine arteries, which raises concerns that compromise of uterine blood flow during pregnancy may lead to foetal growth restriction. We also think this necessitates delivery by caesarean section. We report on six pregnancy outcomes following laparoscopic hysteropexy. Primary outcomes were live birth and birth weight. Secondary outcomes were integrity of mesh and immediate effect on prolapse. Results: All patients had successful pregnancy outcomes with birth weights on or above the 10th centile. There was no effect on mesh integrity seen in any of the cases. There was no deterioration in apical prolapse when assessed post delivery, but two patients had new onset anterior vaginal wall prolapse. Conclusions: We think our technique of hysteropexy is safe for those wishing to conceive. Larger numbers are needed to allow robust evidence-based guidance for patients and clinicians. Keywords: Hysteropexy, Pregnancy, Fertility-preserving prolapse surgery Background this incision down to the right uterosacral ligament, Laparoscopic hysteropexy offers uterine preservation to keeping medial to the ureter. A http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Gynecological Surgery Springer Journals

Pregnancy following laparoscopic hysteropexy—a case series

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2017 by The Author(s).
Subject
Medicine & Public Health; Gynecology; Minimally Invasive Surgery; Surgical Oncology; Obstetrics/Perinatology/Midwifery; Reproductive Medicine; Interventional Radiology
ISSN
1613-2076
eISSN
1613-2084
D.O.I.
10.1186/s10397-017-1017-1
Publisher site
See Article on Publisher Site

Abstract

Background: Uterine-preserving prolapse surgery offers the chance to retain fertility; however, limited data is available for the safety of pregnancy following surgery and the effect of pregnancy on surgical outcome. Our operative technique involves mesh encircling the cervix and uterine arteries, which raises concerns that compromise of uterine blood flow during pregnancy may lead to foetal growth restriction. We also think this necessitates delivery by caesarean section. We report on six pregnancy outcomes following laparoscopic hysteropexy. Primary outcomes were live birth and birth weight. Secondary outcomes were integrity of mesh and immediate effect on prolapse. Results: All patients had successful pregnancy outcomes with birth weights on or above the 10th centile. There was no effect on mesh integrity seen in any of the cases. There was no deterioration in apical prolapse when assessed post delivery, but two patients had new onset anterior vaginal wall prolapse. Conclusions: We think our technique of hysteropexy is safe for those wishing to conceive. Larger numbers are needed to allow robust evidence-based guidance for patients and clinicians. Keywords: Hysteropexy, Pregnancy, Fertility-preserving prolapse surgery Background this incision down to the right uterosacral ligament, Laparoscopic hysteropexy offers uterine preservation to keeping medial to the ureter. A

Journal

Gynecological SurgerySpringer Journals

Published: Aug 17, 2017

References

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