Background: The increasing global rate of Caesarean section (CS) deliveries has coincided with a rise in Caesarean Scar Defect (CSD) also known as Isthmocele, which is emerging as a significant cause of Abnormal Uterine Bleeding (AUB). Despite their clinical relevance, Caesarean Scar Defects remain underdiagnosed.
Objective: To determine the Association of Caesarean Scar Defects (CSD) among women presenting with Abnormal Uterine Bleeding (AUB) with a prior history of Caesarean Section.
Methods: A Prospective Observational study was conducted at GITAM Institute of Medical Sciences and Research, Visakhapatnam, from February 2025 to August 2025 involving 189 women aged 18-45 years presenting with Abnormal Uterine Bleeding (AUB) with ?1 prior Caesarean Section. Clinical evaluation and Transvaginal sonography (TVS) were performed to detect Caesarean Scar Defects.
Results: Among 189 women, 8 (4.2%) were diagnosed with Caesarean Scar Defects on Transvaginal sonography (TVS). In the present study women with two or more caesarean deliveries exhibited a substantially higher CSD association (12.2%) compared to those with a single caesarean section (1.4%). Postmenstrual bleeding (PMB) was observed in 20.5% of women without a CSD and in 50% of those with CSD. No association was found with the Age, Parity, Interval since last Caesarean Section (CS).
Conclusion: Caesarean Scar Defects association among Abnormal Uterine Bleeding (AUB) cases with prior Caesarean Section (CS) was 4.2%. Integration of routine Transvaginal sonography (TVS) evaluation in women with Abnormal Uterine Bleeding (AUB) and previous Caesarean Section (CS) delivery may support early diagnosis and management.
International Journal of Clinical Obstetrics and Gynaecology
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