Incidence of abnormal uterine bleeding with uterine scar defect after cesarean section (uterine niche) (Isthmocele)

Abstract

Introduction:Niche is a long-term complication of Cesarean section (CS), which has sparked growing interest worldwide. Clinical signs are not always present in patients with a niche in their Cesarean scar. Aim of the study:The study aimed to evaluate the prevalence of uterine niche after CS in women with abnormal uterine bleeding. Subjects and Methods:The study included nonpregnant women at the reproductive age (20:38 years) who had a CS more than six months ago, between February 2021 to February 2022, and were applied to the gynecology clinic for abnormal uterine bleeding. Transvaginal Ultrasound (TVS) was used to measure the standard scar parameters: residual myometrial thickness (RMT) and the depth and width of the hypoechoic niche.Results: CS niche was observed by TVS in 23% of women. Postmenstrual spotting was the most common clinical pattern of bleeding found in women with observed niches. Conclusions:There may be a correlation between CS niche and unexplained abnormal uterine bleeding, especially postmenstrual spotting.