[UTERINE SCAR DEFECT IN WOMEN AFTER CESAREAN SECTION - ULTRASOUND AND HYSTEROSCOPIC DIAGNOSI.]

Area of Science:

• Gynecology
• Obstetrics
• Medical Imaging

Background:

• Cesarean section (CS) rates are increasing globally.
• Post-CS complications can significantly impact women's health.
• Uterine scar defects are a recognized complication following CS.

Purpose of the Study:

• To determine the frequency of defect scars after Cesarean section (CS) in women with clinical complaints.
• To compare the diagnostic accuracy of transvaginal ultrasonography and diagnostic hysteroscopy for identifying uterine scar defects.
• To assess the correlation between clinical symptoms and diagnosed scar defects.

Main Methods:

• Retrospective study of 25 premenopausal women aged 29-45 with clinical symptoms post-CS.
• Inclusion criteria: prior CS, gynecological symptoms (e.g., irregular bleeding, dyspareunia), and imaging findings of scar defect.
• Diagnostic methods included two-dimensional transvaginal sonography and diagnostic hysteroscopy.
• Statistical analysis using Chi-square test (p<0.05).

Main Results:

• Post-menstrual bleeding was the most common symptom (88%).
• Ultrasound identified uterine scar defects in 60% of patients (p=0.00407).
• Hysteroscopy confirmed defective scars in 40% of patients (p=0.000004).
• No significant difference in diagnostic accuracy between ultrasonography and hysteroscopy for isthmocele (p=0.1572), though hysteroscopy showed higher statistical significance.

Conclusions:

• Irregular uterine bleeding after CS, without other organic causes, often results from uterine scar defects.
• Ultrasonography is recommended as the initial diagnostic tool, followed by hysteroscopy.
• Further research is needed to explore the etiology of this complication.