The Association between Cesarean Section Niche Diagnosed by Hysteroscopy and Post-menstrual Spotting

Abstract

Cesarean section is the most commonly performed uterine surgical procedure in women of reproductive age. The low transverse incision is the most popular type of hysterotomy. Cesarean section is associated with complications in subsequent pregnancy, such as scar pregnancy with life threatening bleeding, placenta previa, placenta accreta, increta or percreta, dehiscence or uterine rupture. Large defect is associated with higher risk of complication than small defect. Since transvaginal ultrasound has become a routine investigation of the gynecological patient, it has become evident that CSD is a frequent finding with use of high frequency probes and proximity to the uterus allows us to quantify their size. It seems to represent an area of incomplete bridging of the incision edges and is almost always facing into the endometrial space Recognition of scar defect is important in the explanation of certain menstrual disorders since surgical intervention can result in improvement of symptoms and prevent cesarean related secondary obstetric complications