Amy Garcia, MD, is Director, Center for Women’s Surgery and Garcia Institute for Hysteroscopic Training, Albuquerque, and Clinical Assistant Professor, Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque. Dr. Garcia serves on the OBG Management Board of Editors.
Fiberoptic flexible hysteroscopy showing cesarean scar defect in the anterior lower uterine segment of a patient evaluated for abnormal uterine bleeding. When identified hysteroscopically, a definitive out-pouching is visualized in the lower uterine segment, where the defect has been termed an “isthmocele.”