Postnatal diagnosis of an occult uterine scar dehiscence after three uncomplicated vaginal births after Caesarean section: A case report

Postnatal diagnosis of an occult uterine scar dehiscence after three uncomplicated vaginal births after Caesarean section: A case report

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Introduction: The incidence of Caesarean sections has been increasing in the United Kingdom.Obstetricians have become more inclined to offer a trial of a vaginal birth to women following a single uncomplicated Caesarean section due to growing recognition of the high morbidity associated with repeat abdominal surgeries, and the relative rarity of a Caesarean scar defect causing complications at subsequent vaginal deliveries.The diagnosis of a Caesarean scar defect such as a uterine scar dehiscence in the postnatal period still remains elusive due to its vague presentation.An incorrect diagnosis relay board or a delay in diagnosis can lead to unnecessary interventions or delay the management of patient symptoms.

Case Presentation: A 35-year-old woman with a single Caesarean section and three subsequent uncomplicated vaginal deliveries was diagnosed with an occult scar dehiscence two weeks postnatally.She initially complained of persistent vaginal bleeding and underwent a suction evacuation for suspected retained placental tissue.Her symptoms did not improve, and a CT scan was requested to rule out a uterine perforation following the surgical procedure.The CT scan suggested a uterine dehiscence at the level of the previous scar.

As the patient remained clinically well, Blessed Thistle her symptoms were managed conservatively.She underwent a laparoscopic sterilisation six months later and was discharged as the scar defect had fully resolved.Conclusion: Clinicians should remain vigilant about the possibility of an occult scar defect in women with a previous Caesarean section who present with persistent vaginal bleeding and pain in the postnatal period.