Assessment of Uterine Scar and its Possible Defect after Cesarean Section by Transvaginal Ultrasound

Background: The assessment of cesarean section scars and their flaws, both before and during pregnancy, has been made easier by advancements in imaging technology. When transvaginal ultrasonography (TVS) is performed in the non-pregnant state, the scar defect manifests as a wedge-shaped cystic or hypoechoic distortion. Aim and objectives: To describe morphological criteria of cesarean section scars and their defects (niches) detected by transvaginal ultrasonographic scan in non-pregnant women and to associate these criteria with the related gynaecological presentation and risk factors in such patients. Subjects and methods: In December 2021 to December 2023, 300 multiparous, non-pregnant women with a history of prior cesarean deliveries underwent transvaginal ultrasound examinations at Al-Hussein and Sayed Galal Hospital's delivery and emergency department. This cross-sectional study was conducted on them. Result: The frequency of CS scar defect increased with increasing number of vaginal deliveries prior to the cesarean sections. However, the relation showed only a trend towards statistical significance (p=0.077). Scar defect development was substantially linked (p<0.001) with the RVF uterus. The prevalence of CS scar abnormalities was substantially correlated with the number of cesarean sections performed (p=0.003). Conclusion: Transvaginal ultrasonography is a very precise method for identifying scars after cesarean hysterotomies. Multiple cesarean deliveries and labour preceding cesarean delivery were associated with higher rates of cesarean scar defects, which are defined as the presence of fluid within the incision site.