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Objective: To evaluate Cesarean scar defects using saline contrast sonohysterography (SCSH) in women with a history of Cesarean scar pregnancy (CSP). Methods: A cohort of 38 non‐pregnant women with a history of CSP treated with combined local and systemic methotrexate was investigated prospectively by SCSH. For the purpose of analysis, they were classified, according to the modified Delphi consensus criteria for CSP in early gestation, into three subgroups based on the depth of the gestational sac herniation in the midsagittal plane. Subgroup A included eight (21.1%) cases, in which the largest part of the gestational sac protruded towards the uterine cavity; Subgroup B included 20 (52.6%) cases, in which the largest part of the gestational sac was embedded in the myometrium; and Subgroup C included 10 (26.3%) cases, in which the gestational sac was located partially outside the outer contour of the cervix or uterus. Results: SCSH revealed that all women in Subgroup C had a uterine niche. The median niche length (P = 0.006) and depth (P = 0.015) were significantly greater in Subgroup C than in Subgroups A or B. The median residual myometrial thickness (RMT) was significantly lower in Subgroup C than in Subgroups A or B (P = 0.006). Conclusions: Women with prior CSP who had a gestational sac protruding beyond the serosal line had a significantly greater niche length and depth, and lower RMT. This knowledge may guide individualized risk counseling. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article discusses the use of three-dimensional sonography for diagnosing congenital uterine anomalies in women with eccentric pregnancy implantation. The study found that there was a higher incidence of uterine anomalies in cases of eccentric pregnancy implantation compared to concentric pregnancy implantation. Additionally, pregnancies that remained in the eccentric location with uterine malformations resulted in early pregnancy demises, while those that migrated to a more centric location within the endometrial cavity resulted in live births without uterine malformations. The authors suggest that differentiating between eccentric pregnancies in non-anomalous and anomalous uteri is important for management and recommend conducting a 3D-US examination in non-pregnant women to rule out underlying uterine malformations. [Extracted from the article]

Noam Smorgick, Ron Maymon Department of Obstetrics and Gynecology, Assaf HaRofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Abstract: Pelvic ultrasound is commonly used as part of the routine gynecologic exams, resulting in diagnosis of adnexal masses, the majority of which are functional or benign. However, due to the possible complications involving benign adnexal cysts (ie, adnexal torsion, pelvic pain) and the utmost importance of early diagnosis and treatment of ovarian cancer, the correct ultrasound diagnosis of adnexal masses is essential in clinical practice. This review will describe the typical ultrasound appearance of the common physiologic, benign, and malignant adnexal masses with the aim of aiding the clinician to reach the correct diagnosis. Keywords: adnexal cyst, Doppler, ovarian cancer

This article, titled "Sequence of events leading to medical abortion for fetal indications after 34 weeks of gestation: 23-years experience from a single medical centre," presents a retrospective study conducted over a 23-year period on fetal abortions in singleton pregnancies. The study found that 0.88% of abortions were carried out after 34 weeks of gestation, with anatomical indications accounting for 55% of cases, chromosomal or genetic indications accounting for 39% of cases, and other indications accounting for the remaining cases. The study suggests that earlier diagnosis and adherence to screening tests and protocols could have significantly reduced the rate of late abortions. [Extracted from the article]