Evaluation during early puerperium of the low transverse incision after cesarean section through vaginal ultrasonography

This study was designed in order to determine the criteria of the natural healing of the low transverse cesarean incision through vaginal ultrasonography. The uterine wound was examined with a vaginal scanner (5.5-7 MHz) in 75 asymptomatic patients with a normal postoperative course three days after the cesarean section. We compared our findings with those obtained in 21 patients with a complicated post-cesarean course. The uterine incision was identified as an oval, centrally located region between the bladder and the uterus. In 18 of the 75 cases, a hypoechoic area with indistinct limits, almost rounded and with a diameter of smaller than 1.5 cm in all cases was determined in the incision site. Possibly all these cases represented small hematomas or serous collections, with no clinical importance. Four of the 21 symptomatic patients had bladder flap or uterine incision hematomas. These were large (> 2 cm in all cases) hypoechoic areas inside or around the transverse incision site. The low transverse cesarean incision in the uterus can be visualized sonographically with a vaginal scanner and normal postoperative changes can be recognized.