Prevalence and clinical profile of Caesarean Scar Defect after Caesarean Delivery

Cesarean section rates have been rising significantly over recent years, more so in western world; increasing from 14.5% to 27.2% between the years 2000 and 2017. As per a report by the World Health Organization, roughly 18.5 million women undergo CS annually.The rise in caesarean section deliveries in India also has become a notable public health concern. Rise in the number of deliveries by CS has inevitably resulted in prevalence of its complications, both in short and long term. While C-sections can be lifesaving when medically indicated, their overuse can lead to significant health risks for both mothers and infants, including infections, prolonged recovery times, and increased healthcare costs. One important long term complication is Caesarean Scar defect (CSD) also known as Isthmocoele or Niche.The paucity of Indian research on caesarean scar disorder (CSD) highlights a critical gap in understanding the long-term implications of rising caesarean delivery rates in the country. Despite the increasing incidence of CSD and its associated complications, such as chronic pelvic pain, abnormal bleeding, and infertility, there is a notable lack of focused studies addressing its etiology, diagnosis, and management within the Indian context. This gap is concerning as it limits the ability to formulate effective preventive strategies and treatment protocols tailored to local needs. Furthermore, as caesarean sections become more common, the potential long-term sequelae of CSD—such as uterine rupture or placenta accreta—assume greater significance.  Therefore, there is an urgent need for comprehensive research initiatives in India to investigate the multifactorial aspects of CSD, including surgical techniques, patient demographics, and cultural factors influencing healthcare decisions. Addressing this research deficit will not only improve clinical outcomes but also enhance overall maternal health care in India.The aims of this study is to evaluate the incidence of CSD and CSDi by using standard definitions of both.