Indicator analysis of hysteroscope electrotomy for previous cesarean scar defect

Objective: The aim of this study is to evaluate if transvaginal ultrasonography is an accurate diagnosis method for previous cesarean scar defect (PCSD) and to analyze the indicators of the PCSD patients suitable for undergoing hysteroscope electrotomy treatment. Methods: 25 patients with PCSD related clinical symptoms were selected for this study. The patients were first undergone transvaginal ultrasonography for the diagnosis of PCSD and then confirmed by hysteroscopy. All the patients received hysteroscope electrotomy treatment, and were followed up for 24 months, then the therapeutic efficacy of hysteroscopy electrotomy and the indicators of PCSD patients potentially affecting the outcomes were analyzed. Results: The accuracy of transvaginal ultrasound diagnosis for PCSD was 88%. The overall effective rate of hysteroscopy electrotomy for PCSD was 60%. Compared to the overall effective rate, hysteroscopy electrotomy had a significantly higher effective rate in the patients with single cesarean section (83.3%), or anteverted uterus position (90.9%); in contrast, hysteroscopy electrotomy had a significantly lower effective rate in the patients with multiple cesarean section (38.5%), or retroverted uterus position (35.7%), or with multiple cesarean section plus retroverted uterus position (28.6%). Conclusion: Hysteroscopy electrotomy is an effective treatment for PCSD patients with single cesarean history and anteverted uterus position.