The presentation and management of cesarean scar defects: an updated review on an evolving diagnosis

Purpose of review The purpose of this review is to provide a clinically relevant synthesis of the current literature on cesarean scar defects, focusing on their epidemiology and clinical presentation, diagnosis, treatment, and prevention. Recent findings Cesarean scar defects (CSDs) are an emerging area of gynecologic research, with an influx of higher quality cohorts, randomized controlled trials, and systematic reviews published within the last decade. Recent developments of importance include the European Niche Taskforce consensus on the measurement and diagnosis of CSDs, the proposal of clinical criteria for Cesarean scar disorder (CSDi), as well as the publication of several systematic reviews, which provide enhanced support for clinical decision-making in treatment strategies. Areas for continued research include risks factors for CSDs and preventive strategies, as well as their role in obstetrical complications. Summary CSDs are a common sonographic finding. While those incidentally identified in an asymptomatic population require no treatment, CSDs can cause significant burden in the form of abnormal uterine bleeding, pelvic pain, and infertility. Their role in obstetrical complications has yet to be fully elucidated. Given the high incidence of cesarean sections, many - if not all - providers of uterine care will encounter their sequalae. As such, continued awareness amongst all providers regarding their evaluation and management is key.