Incidence of Uterine Cesarean Scar Niche After Cesarean Delivery

Study Overview
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Brief Summary
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To assess the incidence of cesarean scar niche and its risk factors in a prospectively collected population.

Detailed Description
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It will be carried out in Gynecology and Obstetrics department in Beni-Suef University Hospital using Ultrasound: Six months after the cesarean delivery, participants will be invited to the gynecologic outpatient clinic or department for ultrasound (US) examination to detect the presence of the niche. Women without contraception will be examined during the follicular phase of the menstrual cycle to avoid an eventual early pregnancy. Otherwise, a random phase of the menstrual cycle will be accepted. Women who are pregnant at the time of US will be excluded. Women will be examined in the lithotomy position with an empty bladder. The uterus will be examined in a standardized way, with trans-vaginal US performed first. For the diagnosis of cesarean scar niche (defined as an anechoic defect in the anterior wall of the lower uterine segment, communicating with the endometrial cavity),we will use a predetermined definition of a defect at least 2.0 mm deep

Official Title
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Incidence of Uterine Cesarean Scar Niche After Cesarean Delivery and Assessment of Its Risk Factors

Conditions
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Cesarean Section, Dehiscence

Intervention / Treatment
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* Procedure: cesarean section


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Delivery by cesarean section. More than 6 months after delivery. Cesarean section by senior resident or assistant lecturer. Exclusion Criteria: Single layer technique in uterine closure. Uterine anomaly.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 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 |
| --- | --- |
| previous 1 cesarean section<br>patient who had her first Cesarean section | Procedure: cesarean section<br>* caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen<br>|
| previous 2 cesarean sections<br>patient who had her second Cesarean sections | Procedure: cesarean section<br>* caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen<br>|
| previous 3 or more cesarean sections<br>patient who had 3 or more Cesarean sections | Procedure: cesarean section<br>* caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the incidence of cesarean scar niche among cesarean deliveries | number of cases develop cesarean scar niche after cesarean deliveries | 6 months after delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| risk factors that affect the development of the niche. | age- BMI- post operative infection - PROM(preterm rupture of membrane) | within 1 month of delivery |