Chronic Endometritis in Cases with Cesarean Section Scar Defect

Background: The appearance of unhealed CS scar defect (CSD) has brought extensive attention in the last two decades. Aim: To assess the relation between chronic endometritis and cesarean section scar defect. Methods: This study was performed on a total of 60 women who accidentally discovered to have CS scar defect by vaginal ultrasound or by hysteroscope. Office Hysteroscope (without anesthesia) and or transvaginal ultrasound was used to diagnose CSD. We confirmed diagnosis of chronic endometritis by histopathological examination by plasma cell count more than one plasma cell detected through endometrial biopsy. Results: There was a statistically significant difference between histopathological findings and post CS complications among studied patients, as (66.7%) of the patients which had chronic endometritis on histopathology had infertility in comparison to (23.5%) of patients with normal histopathology. As regard pelvic inflammatory disease; (66.7%) of the patients which had chronic endometritis had PID in comparison to (33.3%) of patients with normal histopathology. Although the frequency of bleeding did not significantly differ between the two groups. Conclusion: cesarean scar niche is associated with development of post-cesarean section chronic endometritis and complications of infertility and PID. Consequently, early hysteroscopy and endometrial biopsy may be helpful for infertile women with a CSD.