Two Dimensional Versus Three Dimensional Transvaginal U/S With or Without SIS

Primary aim:

To assess the diagnostic agreement between 2D vs 3D TV U/S with or without SIS for the evaluation of cesarean scar defects and its correlation with symptoms. To compare both imaging modalities regarding assessment of cesarean scar defect parameters, including depth, length, width, anterior myometrial thickness, and residual myometrial thickness, as well as to evaluate procedure time, patient tolerability, and satisfaction.

Secondary aims:

To assess the relation between the size of the niche and the patient symptoms.

Inclusion criteria

• Women aged 20-45 years
• History of at least one previous cesarean section
• Interval since last cesarean section ranging from 6 months to 10 years
• Willingness to participate and provide written informed consent

Exclusion criteria

• Current pregnancy
• Active pelvic infection or acute pelvic inflammatory disease
• Large uterine fibroids distorting the uterine cavity
• History of uterine surgery other than cesarean section (e.g., myomectomy)
• Failure of SIS performance
• Patients on any contraception methods