In plain words
An isthmocele is a notch or thin spot where the uterus was cut for a . The scar is made of new tissue, and sometimes it heals thinner or with a small pocket. It is found on an ultrasound, often months later, and most of the time it causes no symptoms. Some women notice light bleeding between periods, pain during periods, or pain during sex. In rare cases, it can affect how the uterus behaves in a later labor. A thin scar is one factor your provider will weigh when planning a later birth. Ask your provider to explain what a scan shows, and what it means for a future pregnancy. The term is mostly used in clinics and in cesarean recovery information.
The deeper version
An isthmocele, or cesarean scar niche, is a defect in the lower uterine segment at the site, seen on as a hypoechoic indentation with reduced residual myometrial thickness, usually assessed at six months or more after surgery. Reported prevalence varies widely with the definition used and the surgical technique. Associated outcomes include postmenstrual spotting, chronic pelvic pain, , and, in labor, a theoretical risk of uterine rupture. Whether single-layer or double-layer uterine closure, and the suture technique, reduces niche formation is debated, and Cochrane reviews of closure techniques have reported limited certainty. Standard definitions and the threshold for clinical relevance are still under discussion.
Where it comes up
- Cesarean recovery, week by weekPostpartum: Your Body
- Scar care: cesarean and perineal scarsPostpartum: Your Body
- VBAC: birth after a cesareanGetting Ready for Birth
- What happens in a cesareanBirth and the First Days
What mothers here say about isthmocele
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery, 2019