Miscarriages following caesarean section-induced extra-uterine adhesions

A Caucasian lady in her 30s presented with repeated miscarriages following a previous caesarean section. Following ongoing pain and bleeding, and inconclusive imaging, a scan undertaken after her second miscarriage suggested a possible communication through the uterine wall. Subsequent laparoscopy revealed a dense band of adhesions starting from lower segment of uterus and extending all the way to anterior fundus adherent to the anterior abdominal wall. To our knowledge, this is the first published case of repeated miscarriages following extra-uterine adhesions post caesarean section. Although causality cannot be proven, this is an important and potentially treatable diagnosis to consider.