Design: Cross-sectional study
Setting: Tertiary, academic hospital
Patients or Participants: Ninety non-pregnant women screening for the diagnosis of isthmocele that underwent cesarean section from 2020 to 2022.
Interventions: Diagnostic hysteroscopy, magnetic resonance imaging and pelvic transvaginal ultrasound.
Measurements and Main Results: The average age of the women was 34.8±6.3 years. On average, women had 2.0±1.1 cesarean sections. The prevalence of isthmocele on transvaginal ultrasound was 11.3%, on magnetic resonance imaging 66.1% and on hysteroscopy 43.2%. When evaluating the accuracy of the exams considering transvaginal ultrasound as a reference, it was observed that hysteroscopy presented an accuracy of 71.93% and magnetic resonance imaging of 43.8%. When performing an agreement analysis between the methods, a low agreement was observed between them, with hysteroscopy and magnetic resonance imaging in relation to transvaginal ultrasound being 0.12, p<0.001 and 0.10, p<0.001 respectively and also low agreement between hysteroscopy and magnetic resonance imaging (0.17, p=0.014).
Conclusion: The prevalence of isthmocele varies according to the diagnostic method and agreement between tests for diagnosing isthmocele was low.
Leonardo Pinto, JP1, Oliveira Brito, LG*2, Belluomini, RP1, Bennetti-Pinto, CL2, Yela, D1. 1Obstetrics and Gynecology, University of Campinas, Campinas, Brazil; 2Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
