[Cesarean scar defect]

Abstract

Background: Caesarean section has immediate complications and traditional, well known later, but of equal or greater importance are the risks for the next pregnancy, due to the possibility of uterine rupture, placenta accreta, placenta previa, pregnancy or cervical scar hysterorrhaphy, and other complications not well disseminated or known defects associated with scar hysterorrhaphy (dehiscence).

Objective: Show off frequency and caracteristics of the cesarean scar defects.

Material and method: Retrospective and observational study, by reviewing videos of patients subjected to exploration of the endocervical canal and uterine cavity whith hysteroscope in a 5 year period, in patients with a history of previous cesarean section, evaluating the integrity of the scar. The defects were classified into three categories according to the depth of the defect.

Results: Patients with previous c-section, 62.5% had a defect of the closure of the scar. The total dehiscence of the muscular layer was found in patients with 1, 2 and 3 or more c-section, and only 3 cases (12%) of the defects were found at the level of the isthmus.

Conclusion: Cesarean scar defects are more frequent than we assumed. Since they favour obstetric and gynecological obstetric pathology, with the increase in the number of patients who undergo caesarean section, this has become a health problem, and we must know and promote its relationship with abnormal uterine bleeding and secondary sterility.