OBJECTIVE: To study the prevalence of niches in the caesarean scar in a random population, and the relationship with postmenstrual spotting and urinary incontinence. DESIGN: A prospective cohort study. SETTING: A teaching hospital in the Netherlands. POPULATION: Non-pregnant women delivered by caesarean section. METHODS: Transvaginal ultrasound (TVU) and gel instillation sonohysterography (GIS) were performed 6-12 weeks after caesarean section. Women were followed by questionnaire and menstruation score chart at 6-12 weeks, 6 months, and 12 months after caesarean section. MAIN OUTCOME MEASURES: Prevalence of a niche 6-12 weeks after caesarean section, using TVU and GIS. SECONDARY OUTCOMES: relation to postmenstrual spotting and urinary incontinence 6 and 12 months after caesarean section; and niche characteristics, evaluated by TVU and GIS. RESULTS: Two hundred and sixty-three women were included. Niche prevalence was 49.6% on evaluation with TVU and 64.5% with GIS. Women with a niche measured by GIS reported more postmenstrual spotting than women without a niche (OR 5.48, 95% CI 1.14-26.48). Women with residual myometrium at the site of the uterine scar measuring <50% of the adjacent myometrial thickness had postmenstrual spotting more often than women with a residual myometrial thickness of >50% of the adjacent myometrial thickness (OR 6.13, 95% CI 1.74-21.63). Urinary incontinence was not related to the presence of a niche. CONCLUSIONS: A niche is present in 64.5% of women 6-12 weeks after caesarean section, when examined by GIS. Postmenstrual spotting is more prevalent in women with a niche and in women with a residual myometrial thickness of <50% of the adjacent myometrium.
OBJECTIVE: To study the prevalence of niches in the caesarean scar in a random population, and the relationship with postmenstrual spotting and urinary incontinence. DESIGN: A prospective cohort study. SETTING: A teaching hospital in the Netherlands. POPULATION: Non-pregnant women delivered by caesarean section. METHODS: Transvaginal ultrasound (TVU) and gel instillation sonohysterography (GIS) were performed 6-12 weeks after caesarean section. Women were followed by questionnaire and menstruation score chart at 6-12 weeks, 6 months, and 12 months after caesarean section. MAIN OUTCOME MEASURES: Prevalence of a niche 6-12 weeks after caesarean section, using TVU and GIS. SECONDARY OUTCOMES: relation to postmenstrual spotting and urinary incontinence 6 and 12 months after caesarean section; and niche characteristics, evaluated by TVU and GIS. RESULTS: Two hundred and sixty-three women were included. Niche prevalence was 49.6% on evaluation with TVU and 64.5% with GIS. Women with a niche measured by GIS reported more postmenstrual spotting than women without a niche (OR 5.48, 95% CI 1.14-26.48). Women with residual myometrium at the site of the uterine scar measuring <50% of the adjacent myometrial thickness had postmenstrual spotting more often than women with a residual myometrial thickness of >50% of the adjacent myometrial thickness (OR 6.13, 95% CI 1.74-21.63). Urinary incontinence was not related to the presence of a niche. CONCLUSIONS: A niche is present in 64.5% of women 6-12 weeks after caesarean section, when examined by GIS. Postmenstrual spotting is more prevalent in women with a niche and in women with a residual myometrial thickness of <50% of the adjacent myometrium.
Authors: Jonathan L Hecht; Rebecca Baergen; Linda M Ernst; Philip J Katzman; Suzanne M Jacques; Eric Jauniaux; T Yee Khong; Leon A Metlay; Liina Poder; Faisal Qureshi; Joseph T Rabban; Drucilla J Roberts; Scott Shainker; Debra S Heller Journal: Mod Pathol Date: 2020-05-15 Impact factor: 7.842
Authors: Sanne I Stegwee; Ângela J Ben; Mohamed El Alili; Lucet F van der Voet; Christianne J M de Groot; Judith E Bosmans; Judith A F Huirne Journal: BMJ Open Date: 2021-07-02 Impact factor: 2.692
Authors: A J M W Vervoort; L B Uittenbogaard; W J K Hehenkamp; H A M Brölmann; B W J Mol; J A F Huirne Journal: Hum Reprod Date: 2015-09-25 Impact factor: 6.918
Authors: A J M W Vervoort; L F Van der Voet; M Witmer; A L Thurkow; C M Radder; P J M van Kesteren; H W P Quartero; W K H Kuchenbecker; M Y Bongers; P M A J Geomini; L H M de Vleeschouwer; M H A van Hooff; H A A M van Vliet; S Veersema; W B Renes; H S van Meurs; J Bosmans; K Oude Rengerink; H A M Brölmann; B W J Mol; J A F Huirne Journal: BMC Womens Health Date: 2015-11-12 Impact factor: 2.809