Hysteroscopic evaluation of cesarean scar defect features and its correlation with women complaints

Abstract

To identify risk factors in women with previous one cesarean section leading to formation of cesarean scar defect Methods: We conducted a cross sectional observational study between August 2017 and October 2019 involving women admitted to Early Cancer Detection Unit in Ain Shams University Maternity Hospital who had CSD hysteroscopically diagnosed. A total of 110 women with the simultaneous following characteristics were selected: one prior cesarean section, aged between 18 and 35 years and no history of uterine surgery other than CS that could change the cavity anatomy. Results: This study included 110 women with history of one previous CS and CSD hysteroscopically diagnosed. The women age ranged between 18 to 35 years with a mean of 28.5 ± 5 years old. Mean gestational age at CS was 38.2 ±1 weeks and time since CS was 3.05 ± 1.87. The main indication for CS was elective CS on maternal request (40%), (42.7%) of all participants were performed by residents and about half of cases (49.1%) were performed at private hospitals. Conclusion: Multi-factors contribute to development of CSD. Elective CS on maternal request was responsible for increasing CS rate with its associated complications. Hysteroscopy was found to be easy and reliable investigative tool to detect CSD.