Background: In a routine ultrasound examination of non-pregnant women with a previous caesarean section (CS), the prevalence of CS niche ranges from 24–70%. So it is a serious problem affecting large number of women.
Objective: To assess post caesarean section scar defect (PCSD) by trans-vaginal ultrasound and evaluation of its related complications in non-pregnant women.
Patients and methods: The observational prospective cohort study was conducted 200 women who fulfilled the inclusion and exclusion criteria were recruited and enrolled in the study after talking careful history, from all women attended Family planning 6 months or more after previous elective CS at Maternity Hospital of Bab Al Shaareya Hospital.
Results: Women with CS scar niche had significantly, higher uterine length, longer menstrual duration, higher PBAC score, more postmenstrual spotting days, more inter - menstrual spotting days and more dysmenorrhea. The most frequent SC scar niche shape found by transvaginal ultrasonography in the studied women is triangular shape. The complications mostly occur with niche subsequently as follow: Post- menopausal spotting, chronic pelvic pain, subfertility, dyspareunia, and dysuria.
Conclusion: Symptomatic niche incidence rate was 69.5% of women .had a niche detected by TVS and by sonohysterography. Presence of the niche was associated with postmenstrual spotting, heaviness of mensturation and dysmenorrheal which were related to the niche width and depth.