Research on the pathogenesis and prevention of cesarean scar syndrome

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K09616
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Shiga University of Medical Science
• Principal Investigator: Murakami Takashi 滋賀医科大学, 医学部, 教授 (20240666)
• Co-Investigator(Kenkyū-buntansha): 辻 俊一郎 滋賀医科大学, 医学部, 准教授 (30601546) ; 樋口 明日香 滋賀医科大学, 医学部, 客員助教 (90613480)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: secondary infertility / cesarean section

Outline of Final Research Achievements

We investigated the pathogenesis of cesarean scar syndrome, a condition in which the patient presents with excessive menstruation, irregular uterine bleeding, menstrual cramps, painful sexual intercourse and chronic pelvic pain as well as infertility after cesarean delivery. CD138-positive cells were detected in the uterine isthmus wound depression, and inflammatory cytokines were elevated in the uterus, indicating a condition similar to chronic endometritis. Surgical therapy resulted in 70% of pregnancies, contributing to restoration of fertility. A comparative study of suturing methods that can prevent cesarean scar syndrome during cesarean section surgery is ongoing.

Free Research Field

生殖医学　内視鏡手術学

Academic Significance and Societal Importance of the Research Achievements

晩婚化少子化の風潮の中で、挙児希望を有する帝王切開後の続発性不妊症の大きな原因となる帝王切開瘢痕症候群の病態に対する理解を深め、治療方法の選択基準を示したことは、実地臨床上の大きな成果である。
また、帝王切開瘢痕症候群を生じさせない縫合方法の比較試験の結果が明らかになれば、社会的にも大きな反響を呼ぶものと考えられる。