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The cesarean scar is a significant risk factor for the following pregnancies and especially deliveries. In this chapter, we discussed the diagnosis, incidence, detection, manifestations, and prognosis of pregnancy and delivery with cesarean scars. A systematic review of current literature showed that a manifestation of cesarean scars during the following pregnancies is not predictable, in general, although modern visualization technologies could reveal some specific features of scar defects that are associated with complications during pregnancy and delivery. However, there is no factor, which could serve as the main prognostic guide for obstetricians to make a decision for VBAC, thus Edwin Cragin’s phrase “once a cesarean, always a cesarean” has represented the essential healthcare issue over the century. At the moment, the most reasonable measurements to prevent uterine scar complications are reducing the rate of Cesarean Sections, opening the uterus transversely in the lower segment, and stitching the uterus with one layer only continuously using a big needle preferable by Stark technique of Cesarean section.

Cesarean Scar Defect Manifestations during Pregnancy and Delivery