Cesarean scar niche
Citation, DOI and article data
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 previous Cesarean section scar. A niche has been described as the indentation of myometrium of around 1-2 mm 1,4 and due to tethering of the endometrium.
They are encountered in various shapes such as:
- semicircular: considered commonest 4
- triangular: next commonest 4
- 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.
- 1. Sholapurkar SL. Etiology of Cesarean Uterine Scar Defect (Niche): Detailed Critical Analysis of Hypotheses and Prevention Strategies and Peritoneal Closure Debate. (2018) Journal of clinical medicine research. 10 (3): 166-173. doi:10.14740/jocmr3271w - Pubmed
- 2. Fonda J. Ultrasound diagnosis of caesarean scar defects. (2011) Australasian journal of ultrasound in medicine. 14 (3): 22-30. doi:10.1002/j.2205-0140.2011.tb00120.x - Pubmed
- 3. Rodgers SK, Kirby CL, Smith RJ, Horrow MM. Imaging after cesarean delivery: acute and chronic complications. (2012) Radiographics : a review publication of the Radiological Society of North America, Inc. 32 (6): 1693-712. doi:10.1148/rg.326125516 - Pubmed
- 4. Bij de Vaate AJ, Brölmann HA, van der Voet LF, van der Slikke JW, Veersema S, Huirne JA. Ultrasound evaluation of the Cesarean scar: relation between a niche and postmenstrual spotting. (2011) Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 37 (1): 93-9. doi:10.1002/uog.8864 - Pubmed
- 5. Shuchi K. Rodgers, Cheryl L. Kirby, Ryan J. Smith, Mindy M. Horrow. Imaging after Cesarean Delivery: Acute and Chronic Complications. (2012) RadioGraphics. 32 (6): 1693-712. doi:10.1148/rg.326125516 - Pubmed