Almarzuki, U., Ahmed, T., AlBehedy, T., Abdel Dayem, H. (2022). Evaluation of Anatomical Characteristics of Cesarean Scar Niche by Sonohysterography and Diagnostic Hysteroscopy in Women with Secondary Infertility. The Egyptian Journal of Hospital Medicine, 88(1), 2904-2909. doi: 10.21608/ejhm.2022.242993
Usama Helmy Almarzuki; Taha Abdel Fattah Ahmed; Tarek Mohamed AlBehedy; Hussein Mohamed Abdel Dayem. "Evaluation of Anatomical Characteristics of Cesarean Scar Niche by Sonohysterography and Diagnostic Hysteroscopy in Women with Secondary Infertility". The Egyptian Journal of Hospital Medicine, 88, 1, 2022, 2904-2909. doi: 10.21608/ejhm.2022.242993
Almarzuki, U., Ahmed, T., AlBehedy, T., Abdel Dayem, H. (2022). 'Evaluation of Anatomical Characteristics of Cesarean Scar Niche by Sonohysterography and Diagnostic Hysteroscopy in Women with Secondary Infertility', The Egyptian Journal of Hospital Medicine, 88(1), pp. 2904-2909. doi: 10.21608/ejhm.2022.242993
Almarzuki, U., Ahmed, T., AlBehedy, T., Abdel Dayem, H. Evaluation of Anatomical Characteristics of Cesarean Scar Niche by Sonohysterography and Diagnostic Hysteroscopy in Women with Secondary Infertility. The Egyptian Journal of Hospital Medicine, 2022; 88(1): 2904-2909. doi: 10.21608/ejhm.2022.242993
Evaluation of Anatomical Characteristics of Cesarean Scar Niche by Sonohysterography and Diagnostic Hysteroscopy in Women with Secondary Infertility
Background: Cesarean section complications are becoming more common as cesarean scar defects. Objective: This study aimed to evaluate the anatomical characteristics of cesarean scar niche by diagnostic hysteroscopy and sonohysterography in women with unexplained secondary infertility. Patients and methods: This observational cross-sectional study included 100 women who attended our outpatient clinic, complaining of unexplained secondary infertility with a history of at least one CS and showing scar niche in office hysteroscopy followed by re-assessment by saline infusion sonohysterography with the evaluation of scar depth, width, and shape in both methods. Results: The present work revealed that 45 cases had unhealthy (fibrotic) scars, 41 cases had collected blood in the niche, 24 cases had infected scars, 5 cases had endometritis, and 4 cases had a small submucosal polyp, as well as one case, had a small uterine septum. There were 32 cases with post-menstrualspotting, the mean duration of post-menstrualspotting was 2.5 days (±0.9 SD), 19 cases had chronicpelvic pain, 15 cases had both post-menstrualspotting and chronic pelvic pain, 12 cases had dyspareunia. There were 25, 31, and 44 cases that had 2ry infertility ≥ 1, ≥ 2, and ≥ 3 years respectively. There was a non-significant correlation between features of the niche through diagnostic hysteroscopy and correlated symptoms. Conclusion: Cesarean scar may play an intermediate role in fertility. Hysteroscopy is considered the golden standard tool for the diagnosis of different intrauterine lesions, however; the procedure of sonohysterography is well-tolerated, cost-effective, and can be performed in an office-based gynecological practice, and doesn’t require special training.
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