Cesarean scar niche (CS defect ) (isthmocele) mindray newea i9

Cesarean section scar niche:
= CS defect (CSD)
= Isthmocele
Collection of menstrual blood within the niche leading to:
= Abnormal peri-menstrual bleeding
=Pelvic pain
= Painful menstruation and dyspareunia.
Severe or large CSD ( niche):
= An incision of a depth of at least 50 or 80% of the anterior myometrium
= or , the remaining myometrial thickness ≤2.2 mm on trans-vaginal US
Trans-vaginal US
Assess the severity of the niche by:
= Assessment of the thickness of the remaining myometrium over the niche
If 2mm or less == severe defect
= Measuring the percentage of the thickness of the niche to the whole myometrial thickness
If 80% === severe defect

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