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Corresponding Author

Mohammed Taha Abdelfattah Ahmed

Document Type

Case Series

Abstract

Background: The dramatically increased in CS delivery will essentially increase incidence of cesarean scar defects (CSD) rate, which has deleterious effect on mother's health as cesarean scar ectopic pregnancy, placenta previa and morbidly adherent placenta, scar dehiscence, postmenstrual spotting, inter-menstrual bleeding, dysmenorrheal, dyspareunia, and secondary infertility.

Aim and objectives: This study's objectives were to determine the incidence of post-cesarean scar niche as determined by transvaginal sonography (TVS) and saline infusion sonohysterography (SHG) and to reveal its impact on patient's life style.

Subjects and methods: This research was cross-sectional in nature. All patients had a thorough description of the research given to them, and their verbal informed permission was obtained. The research received ethics committee approval. Patients who visited the Department of Obstetrics and Gynecology's outpatient clinics at AL-AZHAR University Hospitals and Zagazig University Hospitals were the subject of the research. Time of the study: from December 2019 to December 2021.

Results: The incidence of CS niche detected by TVS was 37.7% (75/199 patients) while SHG detected 77.9% (155/199 patients), CS niche parameters length, depth, and width were significantly high as measured by SHG compared to TVS and significantly low in RMT as measured by SHG compared to TVS, post menstrual spotting, dysmenorrhea, heavy menstrual bleeding and chronic pelvic pain were significantly high in patients with CS niche.

Conclusion: SHG is more accurate in diagnosis and characterization of CS scar defect. Post menstrual spotting, dysmenorrhea, heavy menstrual bleeding, and chronic pelvic pain were significantly high in patients with CS niche.

Keywords

Cesarean section; Cesarean scar defect; Residual myometrial thickness; Transvaginal ultrasound; sonohysterography.

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