Cesarean scar niche

Last revised by Sze Yuen Lee on 14 Mar 2023

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Lee S, Yap J, et al. Cesarean scar niche. Reference article, Radiopaedia.org (Accessed on 31 May 2023) 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:

14 Mar 2023, Sze Yuen Lee

Disclosures:

At the time the article was last revised Sze Yuen Lee had no financial relationships to ineligible companies to disclose.

View Sze Yuen Lee's current disclosures

Revisions:

11 times, by 7 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.