Hysteroscopy Combined with B-Ultrasonography for Diagnosis of Uterine Incision Diverticulum after Secondary Cesarean Section / 中国微创外科杂志

ABSTRACT

Objective To investigate the diagnostic value of hysteroscopy combined with B -ultrasonography for uterine incision diverticulum after secondary cesarean section . Methods From May 2012 to May 2013, hysteroscopy check was performed in 38 cases with a history of two times of caesarean sections . The hysteroscopic results and ultrasound images were analyzed retrospectively . Results Incision diverticulum was diagnosed in 34 cases by using diagnostic hysteroscopy combined with B-ultrasonography, with a diagnosis rate of 89.5%(34/38).There were 18 cases of mild diverticulum (47.4%), 16 cases of severe diverticulum (42.1%), and 4 cases of good healing (10.5%).Of the 16 cases of severe diverticulum , the distance from top to serosal surface was 1.6-6.0 mm, and the width was 3-17 mm.Preoperative transvaginal ultrasonography ( TVS) showed only 10 cases of uterine incision diverticulum in patients with severe diverticulum , providing a diagnosis rate of 26.3% (10/38).Compared TVS with hysteroscopy combined with B-ultrasonography , there was a significant difference (χ2 =31.091, P=0.000) in the diagnosis rate for uterine incision diverticulum . Conclusion Hysteroscopy combined with B-ultrasonography has a high diagnosis rate for the diagnosis of uterine incision diverticulum in patients with two times of cesarean sections , being worthy of clinical application as a minimally invasive examination method after cesarean sections .