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Have irregular vaginal bleeding
Missed period
Long periods
Bleeding between periods
Spotting
Period not stopping
Bloody vaginal discharge
Not seeing your symptoms? No worries!
This complication occurs in women who have had a cesarean section and the muscle layer of the uterus fails to heal properly in that area. Another name for this condition is cesarean scar defect or uterine niche. It can in some cases cause abnormal vaginal bleeding, pain, and infertility.
Your doctor may ask these questions to check for this disease:
Treatment isn't always necessary, but depending on your symptoms a specialist may recommend medication or surgery.
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
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Q.
Is C-Section Recovery Normal? The Medical Reality & Expert Next Steps
A.
Most C-section recoveries are normal: expect 6 to 8 weeks of gradual healing with incision pain or tightness, lochia, abdominal weakness, fatigue, mild swelling, and short-term mood shifts that steadily improve. There are several factors to consider. Seek urgent care for fever 100.4 F or higher, soaking a pad in an hour, chest pain or shortness of breath, one-sided leg pain, worsening abdominal pain, or severe mood symptoms; ask your doctor about persistent pelvic pain, abnormal bleeding, painful sex, or fertility problems that may point to Cesarean Scar Syndrome, and see below for expert next steps on incision care, gradual walking, pelvic floor therapy, safe scar massage timing, and when to schedule follow up.
References:
* Korb LJ, Cojocaru A, Kuperstock JE, Miller EC. Post-cesarean recovery: the new normal? Am J Obstet Gynecol. 2019 Mar;220(3):235-244. doi: 10.1016/j.ajog.2018.10.007. Epub 2018 Oct 12. PMID: 30678239.
* American College of Obstetricians and Gynecologists. Postpartum Complications: ACOG Practice Bulletin, Number 237. Obstet Gynecol. 2021 Dec 1;138(6):e124-e139. doi: 10.1097/AOG.0000000000004652. PMID: 34942478.
* American College of Obstetricians and Gynecologists. Enhanced Recovery After Cesarean Delivery: ACOG Committee Opinion, Number 799. Obstet Gynecol. 2020 Feb;135(2):e51-e63. doi: 10.1097/AOG.0000000000003666. PMID: 32011116.
* Visscher AJH, van den Akker ES, Korpel-Franssen MA, Klinkenbijl JH, Kuizenga-Wijkamp P, van der Pal-de Bruin KM, Willemsen SP, de Jonge A, van der Post JAM, Bloemenkamp KWM. Long-term health outcomes of women who have undergone cesarean section: a systematic review. BJOG. 2016 Feb;123(3):328-36. doi: 10.1111/1471-0528.13840. Epub 2016 Jan 18. PMID: 26781254.
* Visscher SA, Jager J, de Graaf E, van der Horst-Melissant E, van der Velden-van Nassau MA, van der Pal-de Bruin KM. Maternal psychological well-being and satisfaction with care after cesarean section: A qualitative study. BMC Pregnancy Childbirth. 2023 Aug 29;23(1):614. doi: 10.1186/s12884-023-05915-x. PMID: 37639535.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Dosedla E, Calda P. Outcomes of Laparoscopic Treatment in Women with Cesarean Scar Syndrome. Med Sci Monit. 2017 Aug 22;23:4061-4066. doi: 10.12659/msm.902720. PMID: 28829760; PMCID: PMC5576479.
https://medscimonit.com/abstract/index/idArt/902720Higuchi A, Tsuji S, Nobuta Y, Nakamura A, Katsura D, Amano T, Kimura F, Tanimura S, Murakami T. Histopathological evaluation of cesarean scar defect in women with cesarean scar syndrome. Reprod Med Biol. 2021 Dec 21;21(1):e12431. doi: 10.1002/rmb2.12431. PMID: 35386374; PMCID: PMC8967299.
https://onlinelibrary.wiley.com/doi/10.1002/rmb2.12431JAMA Definition and Criteria for Diagnosing Cesarean Scar Disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10061236/