ArticleBJOG : an international journal of obstetrics and gynaecology2025
Caesarean Scar Endometrial Defects Contribute to Post-Caesarean Abnormal Uterine Bleeding and Chronic Endometritis: A Retrospective Case-Control Study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Combined hysteroscopy and laparoscopy for the treatment of a particular cesarean scar diverticulum disguised as a cervical mass: a case report.International journal of emergency medicine · 2026Article
- Comparison of four imaging modalities for cesarean scar defect: a retrospective study.BMC women's health · 2026Article
- A Rare Case of Cesarean Scar Diverticulum Rupture Induced by Intrauterine Infection in a Non-Pregnant Woman.International medical case reports journal · 2026Article
- Clinical Characteristics and Risk Factors of Coexisting Endometrial Lesions in Patients with Cesarean Scar Defect Undergoing Hysteroscopic Resection for Prolonged Menstruation.International journal of women's health · 2026Article
- High Risk of Chronic Endometritis in Isthmocele-A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
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9 authors.
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Abstract
objectiveTo explore the role of endometrial defects in the pathogenesis of abnormal uterine bleeding (AUB).
designRetrospective case-control study.
settingTwo tertiary centres. POPULATION OR SAMPLE: We included 155 patients with caesarean scar defects (CSDs) who underwent hysteroscopy (69 AUB, 86 non-AUB). Thirty patients with AUB were successfully matched with 30 patients without AUB after propensity score matching (PSM) based on CSD size and number of previous caesarean sections, which indicate myometrial defect severity.
methodsHysteroscopic features of CSD before and after PSM were compared between two groups. Pathological features of 13 patients in each group with biopsies of the CSD surface and uterine endometrium were compared, including endometrial thickness determined by haematoxylin-eosin staining, vascular density identified by CD31 staining and chronic endometritis assessed by plasma cells stained with CD138.
main outcome measuresIncidence of hysteroscopic and pathological features of CSD.
resultsBefore PSM, the AUB group exhibited larger diverticulum sizes and more severe myometrial CSD defects than the non-AUB group. After PSM, five features of endometrial defects demonstrated statistically significant differences: in situ haemorrhage, bloody mucus, epithelial deficiency, exposed blood vessels and hyperplastic vessels. Pathological assessments also revealed significant differences in endometrial thickness of CSD, local vascularization and plasma cell count at CSD between the AUB and non-AUB groups.
conclusionsEndometrial defects at caesarean scars contribute more to AUB than myometrial defects.
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