Diagnostic Methods, Risk Factors of Niches, Related Symptoms and Therapies

Huirne, Judith A.F.; BijdeVaate, Marjolein; Voet, LF van der; Witmer, M.; Brölmann, Hans A.M.

doi:10.1007/978-3-662-44059-9_7

Cited by 1 publication

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“…The degree of cervical dilatation and potentially the contractile effort of the uterine muscle, resulting in thinning at the uterine incision site, were both contributors to the development of faulty uterine scars/niches following cesarean section. It was also hypothesized that persistent inflammation or a specific configuration of myometrial fibers in the region of uterine closure might lead to a disparity at the incision level (9) .…”

Section: Figure (2): Diagnostic Hysteroscopy Findings That Were Not D...mentioning

confidence: 99%

Evaluation of Anatomical Characteristics of Cesarean Scar Niche by Sonohysterography and Diagnostic Hysteroscopy in Women with Secondary Infertility

Almarzuki

Ahmed

AlBehedy

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Cesarean section complications are becoming more common as cesarean scar defects.Objective: This study aimed to evaluate the anatomical characteristics of cesarean scar niche by diagnostic hysteroscopy and sonohysterography in women with unexplained secondary infertility. Patients and methods: This observational cross-sectional study included 100 women who attended our outpatient clinic, complaining of unexplained secondary infertility with a history of at least one CS and showing scar niche in office hysteroscopy followed by re-assessment by saline infusion sonohysterography with the evaluation of scar depth, width, and shape in both methods. Results: The present work revealed that 45 cases had unhealthy (fibrotic) scars, 41 cases had collected blood in the niche, 24 cases had infected scars, 5 cases had endometritis, and 4 cases had a small submucosal polyp, as well as one case, had a small uterine septum. There were 32 cases with post-menstrual spotting, the mean duration of post-menstrual spotting was 2.5 days (±0.9 SD), 19 cases had chronic pelvic pain, 15 cases had both post-menstrual spotting and chronic pelvic pain, 12 cases had dyspareunia. There were 25, 31, and 44 cases that had 2ry infertility ≥ 1, ≥ 2, and ≥ 3 years respectively. There was a non-significant correlation between features of the niche through diagnostic hysteroscopy and correlated symptoms. Conclusion: Cesarean scar may play an intermediate role in fertility. Hysteroscopy is considered the golden standard tool for the diagnosis of different intrauterine lesions, however; the procedure of sonohysterography is well-tolerated, cost-effective, and can be performed in an office-based gynecological practice, and doesn't require special training.

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Section: Figure (2): Diagnostic Hysteroscopy Findings That Were Not D...mentioning

confidence: 99%