Abnormal uterine bleeding in a woman with caesarean scar defect (isthmocele): a case report

Authors

  • Abhishek S. Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India
  • B. Shreevijay Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India
  • Sona M. Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India
  • Shashank Kulkarni Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221307

Keywords:

Isthmocele, CSD, Scar Defect, AUB

Abstract

The caesarean scar defect generally is described as a triangular or circular sonographically anechoic area in the myometrium of the anterior lower uterine segment or cervix at the site of a previous caesarean section. Caesarean section is one of the most commonly performed surgeries and the trend is increasing in the recent years. One long-term complication of caesarean delivery which is not often discussed is the presence of a defect within the uterine scar that is directly associated with a type of abnormal uterine bleeding (AUB) referred to as postmenstrual bleeding. In addition to AUB, presented as pelvic pain, dyspareunia, dysmenorrhea, unexplained infertility. Caesarean scar defect is one such cause of AUB which is overlooked as the history of caesarean section will be many years ago. One such case of woman presenting with abnormal uterine bleeding and pain in abdomen with caesarean defect who was managed in our tertiary care centre reported here.

Author Biographies

Abhishek S., Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India

Senior resident doctor, Department of Radio diagnosis,SBMCH

B. Shreevijay, Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India

Professor, Department of Radio diagnosis,SBMCH

Sona M., Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India

Junior resident doctor, Department of Radio diagnosis,SBMCH

Shashank Kulkarni, Department of Radiodiagnosis, Basaveshwara medical college, hospital and research institute, Chitradurga, Karnataka, India

Junior resident doctor, Department of Radio diagnosis,SBMCH

References

Jose C, Pacheco LA. Isthmocele: A Frequently Overlooked Consequence of a Cesarean Section Scar. J Gynecol Obstet Forecast. 2018;1(1):1006.

Morris H. Surgical pathology of the lower uterine segment caesarean section scar: is the scar a source of clinical symptoms? Int J Gynecol Pathol. 1995;14:16-20.

LM Borges, Scapinelli A, Depes DB, Lippi UG, Lopes RGC. Findings in Patients with Postmenstrual Spotting with Prior Caesarean Section. J Min Inv Gynecol. 2010;17:361-4.

Yazicioglu F, Gokdogan A, Kelekci S, Aygun M, Savan K. Incomplete healing of the uterine incision after caesarean section: Is it preventable? Eur J Obstet Gynecol Reprod Biol. 2006;124:32-6.

Surapaneni K, Silberzweig JE. Cesarean section scar diverticulum: appearance on hysterosalpingography. AJR Am J Roentgenol. 2008;190:870-4.

Vikhareva Osser O, Valentin L. Risk factors for incomplete healing of the uterine incision after caesarean section. BJOG. 2010;117:1119-26.

Ofili-Yebovi D, Ben-Nagi J, Sawyer E, Yazbek J, Lee C, Gonzalez J, et al. Deficient lower-segment Cesarean section scars: prevalence and risk factors. Ultrasound Obstet Gynecol. 2008;31:72-7.

Chin HMS, Ng ZY, Yang L. Postmenopausal bleeding in a woman with caesarean scar defect: A case report; Case Reports in Women's Health. 2020;27:e00235.

Gubbini G, Centini G, Nascetti D, Marra E, Moncini I, Bruni L, et al. Surgical hysteroscopic treatment of cesarean-induced isthmocele in restoring fertility: prospective study. J Minim Invasive Gynecol. 2011;18:234-7.

Downloads

Published

2022-04-27

Issue

Section

Case Reports