Determinants of uterine scarring

Despite current recommendations to encourage vaginal birth, the rate of cesarean sections has increased significantly in recent years, leading to an increase in the rate of uterine scar defects. The association between these defects and multiple maternal comorbidities motivates their study for prevention. Using various online library search engines such as PubMed, Medscape, UpToDate, Cochrane, we selected studies on the factors that cause deficient uterine scarring. In literature, it has various names, such as: isthmocele, niche, uterine scar dehiscence or uterine diverticulum. For this paper, 11 scientific articles were selected, choosing only the factors for which a positive statistical link was observed, meaning the increase of the risk of uterine scar defect. Currently, there is no unanimity on the factors that influence the quality of uterine scarring, for many of the factors analyzed there are also other contradictory studies.