{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:46:56Z","timestamp":1782488816205,"version":"3.54.5"},"reference-count":30,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,15]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2025-269859","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T14:25:12Z","timestamp":1772807112000},"page":"e269859","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["IVF pregnancy following a novel approach of open surgical repair of a failed laparoscopic approach to a large caesarean scar defect"],"prefix":"10.1136","volume":"19","author":[{"given":"Hui Min Angela","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, KK Women's and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Ing","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, KK Women's and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tat Xin","family":"Ee","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women's and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahul Hameed Mohamed","family":"Siraj","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Surgery, KK Women's and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"2026062607552057000_19.3.e269859.1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/uog.19049","article-title":"Sonographic examination of uterine niche in non\u2010pregnant women: a modified Delphi procedure","volume":"53","author":"Jordans","year":"2019","journal-title":"Ultrasound in Obstet & Gyne"},{"key":"2026062607552057000_19.3.e269859.2","unstructured":"World Health Organization . WHO statement on caesarean section rates [internet]. 2015. Available: https:\/\/www.who.int\/publications\/i\/item\/WHO-RHR-15.02"},{"key":"2026062607552057000_19.3.e269859.3","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/uog.17568","article-title":"Outcome of Cesarean scar pregnancy managed expectantly: systematic review and meta\u2010analysis","volume":"51","author":"Cal\u00ec","year":"2018","journal-title":"Ultrasound in Obstet & Gyne"},{"key":"2026062607552057000_19.3.e269859.4","doi-asserted-by":"crossref","unstructured":"Xu XJ , Jia JX , Sang ZQ , et al . Association of caesarean scar defect with risk of abnormal uterine bleeding: results from meta-analysis. 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