Abstract:【Objective】 To estimate the frequency of post-caesarean section scar defects (PCSD) on transvaginal ultrasound

identify factors associated with scar deficiency

evaluate the relationship between PCSD and abnormal uterine bleeding.【Methods】 Three thousand and five hundred women who undergoing Cesarean section were follow-up examined with transvaginal sonography (TVS). They were separated into scar intact group and scar defects group. Medical records were compared between the two groups and risk factors correlated with PCSD were analyzed. The relationships between PSCD and abnormal uterine bleeding were assessed. 【Results】 Of the 3500 patients

cesarean scar defects were detected by transvaginal ultrasound in 788 patients(22.5%). The presence of PCSD was not statistically associated with any medical records. The percentage of retroflexed uterus was higher in scar defects group than scar intact group(68.1% vs 31.9%

P = 0.002). The location of the caesarean section scars of the patients with PCSD was more adjacent or below the internal os than the patient with intact scars (85.5% vs 48.1%

P = 0.003). Women with abnormal uterine bleeding tended to have larger scar defects than those with normal menstruation(width 6.0±3.3 mm vs 3.6±1.4 mm

depth 6.4±2.1 mm vs 5.1±1.3 mm

length 8.4±4.1 mm vs 7.2±3.2 mm) in the PCSD group. 【Conclusion】 Post-caesarean section scar defects was a frequent finding in the women with previous Cesarean section. Retroflexed uterus was more frequently associated with PCSD. PCSD located more adjacent or below the internal os. PSCD is associated with abnormal uterine bleeding. Women with abnormal uterine bleeding tended to have larger scar defects than did those with normal period.