Cesarean Scar Defect Formation After First Cesarean Section.

Study Overview
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Brief Summary
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This study is a prospective observational study which will monitor how cesarean section in the first pregnancy will develop a cesarean scar defect. Patients with planned cesarean section in their first pregnancy and those with an emergency cesarean section will be monitored for one year.

Detailed Description
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Cesarean scar defects, which may develop after cesarean deliveries, are associated with menstrual bleeding problems, infertility, and poor obstetric outcomes. No matter how excellent and standard surgical technique is applied, scar defects may develop after cesarean section. However, when cesarean operation decision is taken, the existing operational conditions can affect the formation of cesarean scar defect in the future. Although the surgical technique is the same, a planned cesarean operation and an emergency cesarean section may differ for a future cesarean scar defect that may develop in the future.

Official Title
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Formation of the Cesarean Scar Defect After the First Cesarean. A Prospective Observational Study of Planned Versus Emergency Cesarean Sections

Conditions
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Cesarean Section Complications, Cesarean Wound Disruption, Cesarean Wound; Dehiscence

Intervention / Treatment
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* Other: Transvaginal sonography at six months after cesarean section
* Other: Transvaginal sonography at twelve months after cesarean section


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-45-year-old patients Patients who have undergone a planned or emergency cesarean section within the 38-42th gestational week. Exclusion Criteria: Spontaneous vaginal birth Preterm birth Pregnant women with an obstetrical or gynecological complication.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Planned Cesarean Group<br>Pregnant women undergoing a planned cesarean section at 38-42 gestational week. | Other: Transvaginal sonography at six months after cesarean section<br>* In the sixth month after cesarean section, Women in both groups will undergo a detailed pelvic examination and transvaginal ultrasonographic evaluation for the cesarean scar defect.<br>* Other names: Transvaginal sonography 6th month after C/S;Other: Transvaginal sonography at twelve months after cesarean section<br>* In the twelfth month after cesarean section, Women in both groups will undergo a detailed pelvic examination and transvaginal ultrasonographic evaluation for the cesarean scar defect.<br>* Other names: Transvaginal sonography 12th month after C/S;|
| Emergency Cesarean Group<br>Pregnant women who are planning to give normal birth between 38-42 weeks of gestation but have to been performed an urgent cesarean section due to an emergency such as acute fetal distress, cephalo-pelvic disproportion or another obstetrical condition. | Other: Transvaginal sonography at six months after cesarean section<br>* In the sixth month after cesarean section, Women in both groups will undergo a detailed pelvic examination and transvaginal ultrasonographic evaluation for the cesarean scar defect.<br>* Other names: Transvaginal sonography 6th month after C/S;Other: Transvaginal sonography at twelve months after cesarean section<br>* In the twelfth month after cesarean section, Women in both groups will undergo a detailed pelvic examination and transvaginal ultrasonographic evaluation for the cesarean scar defect.<br>* Other names: Transvaginal sonography 12th month after C/S;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cesarean Scar Defect (Niche) | The presence of a niche at the site of cesarean delivery scar diagnosed at the time of transvaginal ultrasonography | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postmenstrual spotting | Any vaginal bleeding that occurs after the usual menstrual period. | 7-10 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cesarean scar pregnancy, Isthmocele, Uterine niche, Cesarean scar defect