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Cesarean section scar evaluation by saline contrast sonohysterography
C Regnard1, M Nosbusch, C Fellemans
1Department of Obstetrics and Gynaecology, Free Universities of Brussels (VUB-ULB) CHU Saint-Pierre, Brussels, Belgium.
Summary
Cesarean section scars can develop niches, visible via saline contrast sonohysterography (SCSH). This imaging identified niches in over half of women, with a 6% prevalence of dehiscence, a higher risk than uterine rupture.
Area of Science:
- Reproductive Medicine
- Medical Imaging
- Gynecology
Background:
- Cesarean sections are common, leading to uterine scars.
- Uterine scar complications can impact future pregnancies.
- Identifying scar integrity is crucial for reproductive health.
Purpose of the Study:
- To determine the frequency of uterine scar niches after Cesarean section.
- To investigate the prevalence of dehiscence at the Cesarean scar site.
Main Methods:
- Saline contrast sonohysterography (SCSH) was used in 33 women post-Cesarean.
- Measurements included residual myometrium thickness and niche depth.
- Dehiscence was defined as a niche depth ≥80% of myometrium thickness.
Main Results:
- A niche was identified in 19/33 (57.5%) of women.
- The average niche depth was 4.2 mm.
- Two cases (6%) showed dehiscence, defined by niche depth.
Conclusions:
- Saline contrast sonohysterography can identify uterine niches post-Cesarean in about 60% of cases.
- The observed prevalence of scar dehiscence (6%) is significantly higher than the reported risk of uterine rupture (0.4%).
- These findings highlight the importance of assessing uterine scar integrity.