<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412017000200055</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Importancia ginecológica del istmocele ¿cómo y cuándo tratar?]]></article-title>
<article-title xml:lang="en"><![CDATA[Gynecological importance of the isthmocele ¿When and how to treat?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Melo-Cerda]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Estatal de Oncología del Estado de Sonora Unidad de Colposcopia ]]></institution>
<addr-line><![CDATA[Hermosillo Sonora]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<volume>85</volume>
<numero>2</numero>
<fpage>55</fpage>
<lpage>63</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412017000200055&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412017000200055&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412017000200055&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  OBJETIVO: determinar la incidencia de defectos en el cierre de la histerorrafia, sus síntomas y analizar las conductas terapéuticas.  MATERIALES Y MÉTODOS: estudio observacional, prospectivo y comparativo de pacientes con defectos en el cierre de la histerorrafia, atendidas en la Clínica de Colposcopia del Centro Estatal de Oncología del Estado de Sonora entre el 1 de enero de 2013 y el 31 de diciembre de 2015. Criterios de inclusión: pacientes con citología anormal y antecedente de cesárea, a quienes se practicaron: colposcopia, endocervicocolposcopia e histeroscopia. Criterios de exclusión: problemas técnicos que impidieron la observación del canal endocervical o la histeroscopia, pacientes posmenopáusicas, y las que tuvieran diagnóstico colposcópico de cáncer invasor.  RESULTADOS: se estudiaron 120 pacientes con antecedente de cesárea, que se practicó en diferentes centros hospitalarios, de éstas se excluyeron 25 y quedaron 95 casos: 62 (65%) del grupo A (con defectos en el cierre de la histerorrafia) y 33 (35%) del grupo B (sin defectos en el cierre de la histerorrafia). De los 62 casos con defectos en el cierre de la histerorrafia, 30 (50%) fueron en el cierre de la histerorrafia tipo cúpula, 20 (31%) tipo divertículo y 12 (19%) dehiscencia total. Hubo manchado menstrual en 73% de las pacientes, polimenorrea en 31% y dismenorrea en 33%. Solo 20% de las pacientes sintomáticas refirieron los síntomas como relevantes. El aumento de la vascularidad y el sangrado se encontraron en las pacientes con más síntomas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  OBJECTIVE: The Cesarean Scar Defect (CSD) has been underestimated in frequency and importance. Is necessary to know its incidence, the symptoms, and analyze new therapeutic procedures.  MATERIAL AND METHODS: Observational, prospective and comparative study of patients with defects in the closure of hysterorrhaphy, attended at the Colposcopy Clinic of the State Oncology Center of the State of Sonora between January 1, 2013 and December 31, 2015. Inclusion criteria: Patients with abnormal cytology and previous cesarean section, who were: colposcopy, endocervicocolposcopy and hysteroscopy. Exclusion criteria: technical problems that prevented observation of the endocervical canal or hysteroscopy, postmenopausal patients, and those with a colposcopic diagnosis of invasive cancer.  RESULTS: We found in 65.2%, spotting in a 73.3%, polymenorrhea at 31.3%, and to dysmenorrhea in 32.3%. Only 20% of the symptomatic patients referred the symptom as Relevant. We found "CSDs producers of bleeding" that are related to the patients more systematic.  CONCLUSIONS: The cesarean scar defects are frequent cause of gynecological symptomatology that is irrelevant most of the time. A small number of patients needs treatment, we found CSD that produce bleeding, this cases present relevant symptomatology and require treatment. It is necessary to take this into account to choose the best therapeutic approach.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[istmocele]]></kwd>
<kwd lng="es"><![CDATA[defecto en el cierre de la histerorrafia]]></kwd>
<kwd lng="es"><![CDATA[cicatriz de cesárea]]></kwd>
<kwd lng="es"><![CDATA[sangrado uterino anormal]]></kwd>
<kwd lng="es"><![CDATA[manchado menstrual]]></kwd>
<kwd lng="es"><![CDATA[dehiscencia de histerorrafia]]></kwd>
<kwd lng="en"><![CDATA[Isthmocele]]></kwd>
<kwd lng="en"><![CDATA[Cesarean scare defect]]></kwd>
<kwd lng="en"><![CDATA[Cesarean scare]]></kwd>
<kwd lng="en"><![CDATA[Abnormal uterine bleeding]]></kwd>
<kwd lng="en"><![CDATA[Postmenstrual spotting]]></kwd>
<kwd lng="en"><![CDATA[Wound dehiscence]]></kwd>
</kwd-group>
</article-meta>
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