Association between hysteroscopic findings of previous cesarean delivery scar defects and abnormal uterine bleeding

Taiwan J Obstet Gynecol. 2019 Jul;58(4):541-544. doi: 10.1016/j.tjog.2019.05.020.

Abstract

Objective: The aim of the present study was to describe various hysteroscopic findings of previous cesarean delivery scar defects (PCDS), and evaluate the relationship between these findings and abnormal uterine bleeding.

Materials and methods: This was a retrospective study including patients with abnormal uterine bleeding after a cesarean section. Transvaginal ultrasound and hysteroscopy were used to detect the origin of the symptoms, and the gynecological symptoms and hysteroscopic findings were recorded. Relationships between the hysteroscopic findings and abnormal uterine bleeding were evaluated.

Results: Ninety-six (82.8%) patients presented with intermenstrual bleeding. The most common findings of scar defects on hysteroscopy were increased local vascularization (74.1%) and oozing spots (47.4%). Increased local vascularization on the defect was significantly related to intermenstrual bleeding (p = 0.048).

Conclusion: This study categorized different findings of PCDS under hysteroscopy. Increased local vascularization on the scar defect was significantly related to intermenstrual bleeding.

Keywords: Abnormal uterine bleeding; Hysteroscopy; Intermenstrual bleeding; Previous cesarean delivery scar defect; Transvaginal ultrasound.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / methods
  • Cicatrix / diagnosis*
  • Cicatrix / epidemiology
  • Cicatrix / etiology*
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Hysteroscopy / methods*
  • Incidence
  • Pregnancy
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Taiwan
  • Uterine Hemorrhage / epidemiology*
  • Uterine Hemorrhage / etiology
  • Uterine Hemorrhage / surgery