IVF pregnancy following a novel approach of open surgical repair of a failed laparoscopic approach to a large caesarean scar defect

Hui Min Angela Ho, Sze Ing Tan, Tat Xin Ee, Shahul Hameed Mohamed Siraj
In: BMJ Case Reports · 2026 · vol. 19(3) , pp. e269859 · doi:10.1136/bcr-2025-269859 · PMID:41791771 · W7134037743
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⚙ AI-generated summary by claude@2026-07, 2026-07-16 ⓘ

This case study details a successful IVF pregnancy and uneventful delivery after open surgical repair of a large cesarean scar defect that had previously failed laparoscopic treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

The paper reports a clinical case describing a woman in her late 30s with subfertility and complications attributed to a caesarean scar defect (CSD), characterized by indentation of the prior uterine scar. After an unsuccessful laparoscopic approach, she underwent open surgical repair using a modified myometrial repair technique, and she subsequently conceived via in vitro fertilisation and delivered uneventfully by elective repeat caesarean section at term. The authors frame the article as a case report meant for learning rather than evidence to guide treatment or public health policy. Relevance to endometriosis: the paper is not about endometriosis; it was included in the corpus via a keyword match related to pelvic pathology and reproductive outcomes rather than any explicit endometriosis/adenomyosis analysis.

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Abstract

Caesarean scar defects (CSDs) are a known complication of caesarean section (C-section) that can influence various reproductive outcomes. These defects are characterised by an indentation at the site of the previous caesarean scar, potentially leading to clinical issues such as abnormal bleeding, pelvic pain and infertility. Here, we report and discuss a case of a woman in her late 30s who presented with a series of complications and subsequently subfertility as a result of her CSD and how she was sequentially managed. Following open repair of her CSD with a novel modified myometrial repair technique, she managed to conceive through in vitro fertilisation techniques and delivered uneventfully via elective repeat C-section at term.
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Article Text Abstract Caesarean scar defects (CSDs) are a known complication of caesarean section (C-section) that can influence various reproductive outcomes. These defects are characterised by an indentation at the site of the previous caesarean scar, potentially leading to clinical issues such as abnormal bleeding, pelvic pain and infertility. Here, we report and discuss a case of a woman in her late 30s who presented with a series of complications and subsequently subfertility as a result of her CSD and how she was sequentially managed. Following open repair of her CSD with a novel modified myometrial repair technique, she managed to conceive through in vitro fertilisation techniques and delivered uneventfully via elective repeat C-section at term. - Pregnancy - Reproductive medicine Statistics from Altmetric.com Footnotes Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: HMAH, SIT, TXE, SHMS. The following authors gave final approval of the manuscript: HMAH, SIT, TXE, SHMS. TXE is the guarantor of this paper. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed.

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infertility

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