{
  "abstract": "Isthmocoele is an indentation at the caesarean scar caused by inadequate myometrial healing, leading to symptoms such as abnormal uterine bleeding, pelvic pain and secondary infertility. It appears as a hypoechoic collection at the scar site on transvaginal ultrasound, often with a residual myometrial thickness (RMT) <3 mm. We present a case of a woman in the late 30s, who is a multipara with three prior caesarean sections. She presented with a 2-year history of irregular prolonged intermenstrual bleeding and pelvic pain. Transvaginal sonography revealed a 1.2×1.5 cm niche with RMT of 2.8 mm. As medical therapy failed, she underwent successful laparoscopic isthmocoele repair with complete symptom resolution. A follow-up imaging confirmed restoration of normal uterine anatomy. This case highlights the efficacy of laparoscopic repair in managing symptomatic isthmocoele with thin residual myometrium.",
  "authors": [
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Government Medical College Hospital Kottayam, Kottayam, Kerala, India"
      ],
      "name": "Vaishnavi Rajaraman"
    },
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India"
      ],
      "name": "Sudha Sumathy"
    },
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Amrita Institute of Medical Sciences, Faridabad, Haryana, India"
      ],
      "name": "Deepti Sharma"
    },
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India"
      ],
      "name": "Kiran Kishore"
    }
  ],
  "title": "Laparoscopic isthmocele repair in a multipara with persistent abnormal uterine bleeding",
  "uid": "95879a28-6e59-5b94-81ba-76896d4172b8"
}