الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Cesarean section can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche, which may be associated with abnormal uterine bleeding and other gynecological symptoms such as dysmenorrhoea, chronic pelvic pain, dyspareunia and secondary infertility.
Aim of the work: this study aimed to evaluate the prevalence of cesarean section niche in patients complaining of unexplained abnormal uterine bleeding.
Methods: The study was a cross sectional study, including 95 women presenting with abnormal uterine bleeding and had a history of previous cesarean section.
Results: As regards prevalence of niche in our study, hysteroscopy was the gold standard test for diagnosis of CS niche. The reported prevalence of CS niche was 47.4% by hysteroscopy and 26.3% by TVS. The diagnostic accuracy of TVS for diagnosis of niche was examined versus hysteroscopy; Sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of TVS for diagnosis of CS niche were 55.6 %, 100 %, 100 %, 71.4 % and 79.0 % respectively.
Conclusion: CS niche was observed by hysteroscopy in 47.4% of women. Postmenstrual spotting was the most common clinical pattern of bleeding found in women with observed niche. Therefore, there may be a correlation between CS niche and unexplained abnormal uterine bleeding especially post menstrual spotting.