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Low uterine segment transverse Cesarean Section is the most frequently performed surgery in obstetrics with a reported frequency of 31.9% of deliveries in the USA reported by the CDC [1]. While Cesarean Section is an indispensable tool in Obstetrics, like all surgical procedures it carries risks. As a procedure performed in young and for the most part healthy women, the incidence of severe morbidity and mortality is relatively low, approximating 2.9% [2] nevertheless we are recently identifying additional risks, such as that of Post-Cesarean Syndrome [3-7]. That has been defined broadly as symptoms resulting from the presence of a defect in the lower uterine segment (Lower Uterine Segment Transverse Incision Defect, LUSTIDs). Such symptoms can be pain, bleeding [7] and dysmenorrhea [6]. In addition, the likelihood of a larger defect increases with retro flexion and repeat cesarean deliveries [6]. Such cases are also identified at the time of delivery and the thickness of the remaining lower uterine segment wall is a determinant of the likelihood of complications during labor. In a more recent identified expression of LUSTIDS is infertility, as documented by failure to conceive in the absence of any other cause of infertility [3,8]. We present a case series of patients with LUSTIDS, starting with a Cesarean Section Ectopic managed with primary intent repair at the time of Hysterotomy. ABSTRACT The aim of this paper is to present the first patient where a lower uterine segment transverse incision defect that led to a cesarean section scar ectopic pregnancy was repaired at the same time with Hysterotomy for removal of her persistent ectopic pregnancy. We also reviewed the literature.

Lower Uterine Section Transverse Incision Defect and Ectopic in the Cesarean Section Scar: A Case Presentation and Review of The Literature