Vaginal ultrasonographic and hysterosonographic evaluation of the low transverse incision after caesarean section: Correlation with gynaecological symptoms

Mario Menada Valenzano, Davide Lijoi, Emanuela Mistrangelo, Sergio Costantini, Nicola Ragni

Research output: Contribution to journalArticle

Abstract

Aim: We investigated whether there is a correlation between morphological changes of the lower uterine segment after caesarean section (CS), visualized by means of either a transvaginal sonography (TVS) or a sonohysterography (SHG), and the frequency of abnormal uterine bleedings reported by the women. Methods: By means of a random selection of our population, anamnesis, medical records, and TVS and SHG images of the lower uterine segment were collected in 217 women (116 with previous CS and 101 with previous vaginal birth), and an observational case-control study was performed. Results: The uterine incision was identified in almost all women after CS (102/116) using TVS. It was observed that abnormal uterine bleeding was significantly more frequent in the CS group in comparison with the group of women who delivered vaginally. A correlation between the presence of abnormal uterine bleeding and the presence of significant sonographic findings in the lower uterine transverse incision in the women after CS was found. In the CS group, TVS findings were confirmed by those obtained by SHG, and, with this technique, a triangular anechoic area at the presumed site of incision (the niche) was identified in 69 of the 116 women (59.5%). Conclusions: In this study, we found a correlation between abnormal uterine bleeding and sonographic findings in women after CS. This correlation appears to be more significant in women who had CS 5-10 years ago. A significant difference exists between the CS group and the group of women who delivered vaginally for both frequency of abnormal uterine bleeding and sonographic findings.

Original languageEnglish
Pages (from-to)216-222
Number of pages7
JournalGynecologic and Obstetric Investigation
Volume61
Issue number4
DOIs
Publication statusPublished - May 2006

Keywords

  • Caesarean section scars
  • Sonohysterography
  • Uterine bleeding
  • Uterine niche
  • Vaginal sonography

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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