Ultrasound findings in the evaluation of cesarian scar defects

Abstract

OBJECTIVES: With the increasing number of cesarean sections worldwide, the investigation of uterine cesarean scarring has become more important in obstetrics and gynecology. This is because the scar can alter the local anatomy and compromise the future, predisposing patients to pathologies such as placenta previa, placental accretion, uterine rupture, endometriosis, ectopic gestation in the scar niche or abnormal post-menstrual uterine bleeding. Although these risks are well known, the long-term effects of caesarean section have been poorly studied, and only a few studies have recently been undertaken to assess the integrity of the uterine region with scars from previous caesarean sections. Because it is a safe and non-invasive method, ultrasonography has been the method of choice used in the investigation of the region of the cesarean scar. Ultrasound imaging in the first trimester is important in detecting cesarean scar ectopic pregnancies and thus the key to prevent associated morbidity and mortality. In patients with a history of cesarean delivery, the anterior lower uterine segment should be closely evaluated by ultrasound in the first trimester.