Doctor Le Duc Thang, a Level I Specialist at Tam Anh General Hospital Hanoi, confirmed via ultrasound that Ms. Lanh's uterus had multiple scar defects, the largest measuring 11,5x5,3 mm, along with fluid retention in the uterine cavity.

A cesarean scar defect occurs when the incision in the lower uterine segment does not heal completely, leaving a niche at the old scar site. Menstrual blood and fluid can accumulate in this defect, flowing back into the uterine cavity. This causes inflammation, deforms the uterine lining, and makes it difficult for embryos to implant and develop. Doctor Thang explained that this inflammation also hinders sperm movement, reducing natural conception rates and causing secondary infertility for Ms. Lanh and her husband.

Ms. Lanh underwent hysteroscopic surgery to excise the scar defects and restore the uterine cavity's shape. After treatment, due to their age, she and her husband chose in vitro fertilization (IVF) to conceive.

Ms. Lanh received ovarian stimulation, resulting in the retrieval of six eggs. These were used to create and culture two day-5 and two day-6 embryos in the lab. She became pregnant on her first day-5 embryo transfer.

Obstetricians and gynecologists at the Center for Obstetrics and Gynecology closely monitored Ms. Lanh's pregnancy due to risks such as implantation on the old scar, scar dehiscence, or uterine rupture. In the 38th week of pregnancy, Ms. Lanh successfully gave birth to a baby boy weighing 2,9 kg via cesarean section.

Doctor Thang transfers an embryo to Ms. Lanh. Photo: Tam Anh General Hospital

Doctor Thang estimates that 24-70% of women who have had a cesarean section will experience scar defects at least once. The risk is higher for those with diabetes, who are overweight, or obese. While cesarean scar defects do not typically pose an acute danger, they can lead to prolonged menstruation, secondary infertility, and increased risks of pregnancy complications like implantation on the old scar, placenta accreta, or scar rupture. Therefore, women experiencing prolonged menstruation or difficulty conceiving naturally after a cesarean section should seek early medical examination at reputable healthcare facilities for timely diagnosis and treatment.

Van Anh

*Patient's name has been changed.