Post Cesarean Section Scar Niche, Prevalence and Impact on Patient's Life Style

Background : The dramatic increase in cesarean section (CS) delivery will essentially increase incidence of cesarean scar defect rate, which has a deleterious effect on mother ' s health as cesarean scar ectopic pregnancy, placenta previa and morbidly adherent placenta, scar dehiscence, postmenstrual spotting, intermenstrual bleeding, dysmenorrheal, dys-pareunia, and secondary infertility. Aim and objectives : This study ' s objectives were to determine the incidence of postcesarean scar niche as determined by transvaginal sonography (TVS) and saline infusion sonohysterography (SHG) and to reveal its effect on patient ' s lifestyle. Patients and methods : This research was cross-sectional in nature. All patients were thoroughly apprised of the description of the research, and their verbal informed permission was obtained. The research received approval of the ethics committee. Patients who visited the Department of Obstetrics and Gynecology ' s outpatient clinics at Al-Azhar University Hospitals and Zagazig University Hospitals were the participants of the research. The study was performed from December 2019 to December 2021. Results : The incidence of CS niche detected by TVS was 37.7% (75/199 patients), whereas SHG detected 77.9% (155/199 patients). CS niche parameters such as length, depth, and width were signi fi cantly high as measured by SHG compared with TVS and signi fi cantly low in residual myometrial tissue as measured by SHG compared with TVS. Postmenstrual spotting, dysmenorrhea, heavy menstrual bleeding, and chronic pelvic pain were signi fi cantly high in patients with CS niche. Conclusion : SHG is more accurate in diagnosis and characterization of cesarean scar defect. Postmenstrual spotting, dysmenorrhea, heavy menstrual bleeding, and chronic pelvic pain were signi fi cantly high in patients with CS niche.