Experts Define Cesarean Scar Disorder

WEDNESDAY, April 5, 2023 (HealthDay News) -- Experts have a standardized definition for the constellation of symptoms resulting from a symptomatic uterine cesarean scar, according to a study published online March 29 in JAMA Network Open.

Saskia J.M. Klein Meuleman, M.D., from the Amsterdam University Medical Center in the Netherlands, and colleagues used a modified Delphi procedure (three rounds) to achieve consensus among 31 international gynecologists on the definition, symptoms, conditions to exclude, and diagnostic criteria of a cesarean scar disorder.

The researchers reported that experts agreed to name this condition cesarean scar disorder, which was defined as a uterine niche in combination with at least one primary or two secondary symptoms (rate of agreement, 77.8 percent). Primary symptoms included postmenstrual spotting, pain during uterine bleeding, technical issues with catheter insertion during embryo transfer, and secondary unexplained infertility combined with intrauterine fluid, while secondary symptoms included dyspareunia, abnormal vaginal discharge, chronic pelvic pain, avoidance of sexual intercourse, odor associated with abnormal blood loss, secondary unexplained infertility, secondary infertility despite assisted reproductive technology, negative self-image, and discomfort during participation in leisure activities.

"Using a standardized definition for the constellation of symptoms resulting from a symptomatic uterine cesarean scar will allow better recognition of this condition, improve patient care, prevent overtreatment, and create a patient-centric foundation of niche-related research in the future," the authors write.

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