Gynecologic Ultrasound Scientific and Case Reports Session
Perioperative Gynecologic Ultrasound for Cesarean Scar Niche Repair
Monday, April 8, 2024
4:32pm – 4:39pm
Location: 412
Authors: Daniel Nassar, University of California (UCLA) Health Ido Mick, McMaster University/HHS Mathew Leonardi, McMaster University
Cesarean scar niche (CSN) is a defect in the uterine scar frequently seen on ultrasound, even after a single cesarean delivery. With current rates of cesarean birth, assessing for CSN with individuals experiencing prolonged menstrual bleeding, impaired fertility, or pelvic pain is essential. Application of gynecologic ultrasound is a critical tool for identifying the presence of a CSN and provides measurements that may help inform clinicians in selecting managements strategies. In this case report, a 41-year-old patient with two prior cesarean deliveries was diagnosed with a CSN after experiencing prolonged menstrual bleeding and early pregnancy loss. Preoperative and perioperative ultrasound were used to augment the laparoscopic CSN repair that was performed. Ultrasound provided real-time comparison between the CSN before the start of surgery and after the repair was completed, in addition to identifying bladder adhesions prior to the operation. This application of ultrasound aided in the diagnosis and management of CSN. Further similar utilization of ultrasound may help to create the best treatment plans for individual patients suffering from the sequelae of CSN.