Accuracy of multimodal vaginal ultrasound in the detection and assessment of scar healing after caesarean section: a correlational meta-analysis

To evaluate the accuracy of multimodal vaginal ultrasound in assessing post-caesarean scar healing. A systematic review and meta-analysis were conducted on Chinese and English studies using multimodal vaginal ultrasound to diagnose poor scar healing post-CS. Two researchers screened literature based on inclusion/exclusion criteria. Quality assessment and meta-analysis (RevMan 5.4, Stata14.0, Meta-DiSc1.4) were performed for various diagnostic indicators. Twenty-five high-quality studies identified key ultrasound markers: hypoechoic/anechoic scars (sensitivity 92%, specificity 91%), thinning/discontinuity of the myotomy layer (sensitivity 95%, specificity 90%), blurred incision contour (sensitivity 99%, specificity 91%), absent blood flow (sensitivity 92%, specificity 91%), irregular lesion morphology (sensitivity 95%, specificity 90%), uneven myometrial echogenicity (sensitivity 94%, specificity 91%), lower uterine segment thickness ≤3.73 mm (sensitivity 90%, specificity 88%), and myometrial lining ≤1.5 mm (sensitivity 90%, specificity 92%). Multimodal vaginal ultrasound is highly accurate in detecting poor CS scar healing, aiding early intervention to prevent complications.