Cesarean scar niche

Last revised by Karen Machang'a on 15 Oct 2023

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Machang'a K, Lee S, et al. Cesarean scar niche. Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-62504

DOI:

https://doi.org/10.53347/rID-62504

Permalink:

https://radiopaedia.org/articles/62504

rID:

62504

Article created:

20 Aug 2018, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

15 Oct 2023, Karen Machang'a ◉

Disclosures:

At the time the article was last revised Karen Machang'a had no financial relationships to ineligible companies to disclose.

View Karen Machang'a's current disclosures

Revisions:

11 times, by 9 contributors - see full revision history and disclosures

Systems:

Obstetrics

Synonyms:

Cesarean scar niches
CS niche
Cesarean scar defect
Cesarean scar defects

The term cesarean scar niche (defect) refers to the presence of a hypoechoic area within the myometrium in the isthmus (lower uterine segment) with discontinuation of myometrium at the site of a previous cesarean section scar. A niche has been described as the indentation of myometrium of around 1-2 mm ^1,4 due to tethering of the endometrium.

They are encountered in various shapes such as:

semicircular: considered commonest ⁴
triangular: next commonest ⁴
droplet‐shaped
inclusion cysts

Due to tethering of the endometrium, blood accumulates in a niche and may serve as a source of dysfunctional uterine bleeding, accounting for spotting 2-12 days after the routine menstrual cycle ⁵.