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- Morphological and biomechanical characterization of early cesarean section scars: a cross-sectional observational studyPublication . Kiselova, Liliya; Pacheco, Camila Maria Ribeiro; de Mattos, Ana Carolina Pucci; Noites, Andreia; de Almeida Fontes, Ana Paula; Guirro, Elaine Caldeira de OliveiraCesarean section is a surgical procedure that involves the extraction of the fetus, the placenta, and the fetal membranes through an abdominal and uterine incision. As one of the most common childbirth methods worldwide, its increasing prevalence has raised concerns regarding potential postoperative sequelae that may affect tissue mobility, pain perception, and functional recovery. However, detailed characterization of early cesarean scars remains limited. This study aimed to characterize the morphological, sensory, and biomechanical properties of cesarean section scars during the early postoperative phase. A cross-sectional observational study was conducted including 20 women evaluated between 15 and 30 days after cesarean delivery. Clinical and sensory assessments were performed using the Patient and Observer Scar Assessment Scale (POSAS 3.0) and pain evaluation. Tissue mobility was assessed using a modified adheremeter, while biomechanical properties were measured with the MyotonPRO device. Ultrasound imaging was used to evaluate structural tissue characteristics. The scars predominantly exhibited increased tissue stiffness and heterogeneous texture patterns. Participants reported moderate pain intensity (mean 4.15 ± 2.18), with slightly higher scores in the patient-reported POSAS compared with the observer scale. Ultrasound findings revealed dermal and hypodermal edema in most participants and signs of fibrosis, with regional heterogeneity in tissue adhesions. Biomechanical analysis confirmed reduced tissue deformability in scar tissue compared with adjacent healthy tissue. These findings indicate that early cesarean scars present relevant structural and functional alterations, highlighting the importance of early assessment to support individualized rehabilitation strategies.