Effect of cesarean delivery on the endometrium

ObjectiveTo compare endometrial tissue samples from cesarean scar (CS) sites and from the posterior uterine wall to better understand the pathophysiology of implantation into a CS.MethodsEndometrial samples were taken from both a CS site and the posterior wall in premenopausal women with CSs, and from the posterior wall in premenopausal women who had spontaneous vaginal deliveries (SVDs) only.ResultsIn the secretory phase, there were significantly fewer leukocytes at CS sites than in the endometrium of women who had SVDs only (P < 0.05). Significant differences in leukocytic infiltration and cell proliferation between the proliferative and secretory phases were only found in women who had SVDs only (P < 0.05).ConclusionLeukocyte recruitment to the endometrium during the secretory phase may be affected by the presence of a CS.