{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:45:48Z","timestamp":1785757548886,"version":"3.56.0"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"7","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sao Paulo Research Agency","award":["18\/18334-9"],"award-info":[{"award-number":["18\/18334-9"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to estimate the prevalence of isthmocele using transvaginal ultrasound, magnetic resonance imaging and diagnostic hysteroscopy.  METHODS: A cross-sectional study conducted from 2020 to 2022 in tertiary academic hospital with ninety non-pregnant women with a history of cesarean section. Transvaginal ultrasound (n=90), magnetic resonance imaging (n=65) and office diagnostic hysteroscopy (n=81) were performed within a short interval for each patient.  RESULTS: The women had a mean age of 34.8\u00b16.3 years, mean number of 2.0\u00b11.1 cesarean sections and mean duration of 40 months since their last cesarean. The prevalence of isthmocele with 95%CIs was 11.3% (5.5\u201319.7%) on transvaginal ultrasound, 66.1% (53.3\u201377.4%) on magnetic resonance imaging, and 43.2% (32.2\u201354.6%) on diagnostic hysteroscopy. When transvaginal ultrasound was considered reference, accuracy for diagnostic hysteroscopy was 57.89% (44.1%; 70.6%) and magnetic resonance imaging, 43.86% (30.9; 57.5%); when magnetic resonance imaging was reference, accuracy for diagnostic hysteroscopy was 54.39% (40.75; 67.43%). Agreement analysis (kappa) among the methods showed low scores between diagnostic hysteroscopy and magnetic resonance imaging regarding transvaginal ultrasound (0.126, p&lt;0.001 and 0.103, p&lt;0.001, respectively) and between diagnostic hysteroscopy and magnetic resonance imaging (0.206, p=0.014).  CONCLUSION: The prevalence of isthmocele was lower in transvaginal ultrasound and higher in magnetic resonance imaging. Accuracy varied from 43 to 58% among the three methods and agreement between tests for diagnosing isthmocele was low.<\/jats:p>","DOI":"10.1590\/1806-9282.20260589","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:00:32Z","timestamp":1785754832000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of isthmocele according to diagnostic hysteroscopy, transvaginal ultrasound, and magnetic resonance imaging in non-pregnant women: cross-sectional study"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-8230","authenticated-orcid":false,"given":"Jo\u00e3o Paulo","family":"Leonardo-Pinto","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8460-5500","authenticated-orcid":false,"given":"Renata Telles Piva","family":"Belluomini","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7364-4718","authenticated-orcid":false,"given":"Luiz Gustavo Oliveira","family":"Brito","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0670-4530","authenticated-orcid":false,"given":"Jamal","family":"Mourad","sequence":"additional","affiliation":[{"name":"Mayo Clinic Arizona,  United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6198-5593","authenticated-orcid":false,"given":"Cristina Laguna","family":"Benetti-Pinto","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3889-4778","authenticated-orcid":false,"given":"Daniela Angerame","family":"Yela","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/00004347-199501000-00004","article-title":"Surgical pathology of the lower uterine segment caesarean section scar: is the scar a source of clinical symptoms?","volume":"14","author":"Morris H","year":"1995","journal-title":"Int J Gynecol Pathol"},{"issue":"6","key":"ref2","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.jmig.2016.06.020","article-title":"Emerging manifestations of cesarean scar defect in reproductive-aged women","volume":"23","author":"Tulandi 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