الفهرس 
Cesarean Scar DefectOnly 14 pages are availabe for public view
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Abstract
R
ising CS rates coincide with increasing its complications and prevalence of cesarean scar defect formation with its gynecological and obstetric complications. CSD defined as a reservoir-like pouch on the anterior wall of the uterine isthmus located at the site of a previous cesarean delivery scar.
This cross-sectional observational study was performed in Early Cancer Detection Unit and Gynecological Endoscopy in Ain Shams Maternity Hospital during the period between January 2018 and October 2019.
Women with at least one cesarean section underwent hysteroscopic evaluation after being screened for the inclusion and exclusion criteria. The first 200 women with CSD were enrolled in our study and the various gynecological complaints prevalence was observed.
Our study group aged between 18 to 35 years with a mean of 29± 5 years, mean gestational age at the last CS was 38 ±1 weeks and time since the last CS was 2.92 ± 1.87 years.
The vast majority of the participants had only one previous CS accounting for 55% of all participants, 75.5% of our participants underwent elective CS and 24.5% underwent an emergency CS with about half of CSs were performed at private hospitals (51.5%) with the majority of cases were performed by a resident in (40.5%) of all participants.
While the main presenting complaint was secondary infertility in (38.5%) of women by taking a detailed menstrual history we found that 51% of all participants were complaining of postmenstrual spotting, 13.5% had prolonged menstrual bleeding, 19.5% had heavy menstrual bleeding while intermenstrual bleeding occurred in 43% of women.
Nearly half of our participants complained of dyspareunia (46%) while 21.5% experienced urinary incontinence and 11% complained of chronic pelvic pain.
Regarding the hysteroscopic appearance of CSD, the most common cesarean scar defect shapes represented as myometrial defect, abnormal vascular pattern on scar in (25%) of participants and polyp like niche in (20.5%) of the studied group.
As our study was designed as cross sectional observational study hence, the results may not be applicable to the general population within these limitations our study did demonstrate that there are different CSD shapes need further studies to understand its relation to various gynecological symptoms.