title: Findings in patients with postmenstrual spotting with prior cesarean section.
abstract: OBJECTIVE
  Throughout the years, patients previously submitted to C-sections may have abnormal uterine bleeding (AUB) of the post-menstrual spotting type. This symptom has been correlated to an anatomical defect on the anterior uterine wall. The objective of the present investigation was to assess the hysteroscopy findings of women at reproductive age, previously submitted to cesarean sections and complaining of post-menstrual spotting, stressing the diagnosis of isthmocele.
  
  
  METHODS
  Prospective study (Canadian Task Force II).
  
  
  METHODS
  State public hospital-Department of Gynecological Endoscopy.
  
  
  METHODS
  Forty-three patients at reproductive age previously submitted to one or more cesarean sections, complaining of AUB of the post-menstrual spotting type, were submitted to diagnostic hysteroscopy in order to assess the presence of anterior uterine wall isthmocele.
  
  
  METHODS
  Hysteroscopic diagnoses.
  
  
  RESULTS
  The mean number of previous C-sections was 2, the average time of post-menstrual spotting observation was 6 years and the mean duration of each episode was 6 days. The hysteroscopic diagnosis of isthmocele was conclusive in 38 patients (88.37%).
  
  
  CONCLUSIONS
  Patients with previous C-sections complaining of postmenstrual spotting type of AUB have a high prevalence of isthmocele, and this condition is likely diagnosed through diagnostic hysteroscopy.
authors.affiliation: Hospital Servidor Publico Estual São Paolo, Endoscopia Ginecologica, São Paolo, Brazil. layzamerizio@yahoo.com.br
authors.forename: Layza Merizio
authors.initials: LM
authors.lastname: Borges
authors.forename: Alessandro
authors.initials: A
authors.lastname: Scapinelli
authors.forename: Daniella
authors.initials: D
authors.lastname: de Baptista Depes
authors.forename: Umberto Gazzi
authors.initials: UG
authors.lastname: Lippi
authors.forename: Reginaldo Guedes
authors.initials: RG
authors.lastname: Coelho Lopes
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008796:Metrorrhagia / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D014599:Uterus / Q000601:surgery*