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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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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