The value of hysterography in the prediction of cesarean section wound defects

Poidevin, L. O. S.

doi:10.1016/s0002-9378(16)36308-6

Cited by 55 publications

(39 citation statements)

References 2 publications

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“…A wedge-shaped defect in the uterine wall following CS was first described using hysterosalpingography in 1961 (Poidevin, 1961). The terminology used to describe these scar abnormalities, scar defects, or niches in the uterine scar, differs in the various publications on this subject (Osser et al, 2009;Bij de Vaate et al, 2011;Naji et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Why Do Niches Develop in Caesarean Uterine Scars? Hypotheses on the Aetiology of Niche Development

Vervoort

Uittenbogaard

Hehenkamp

et al. 2016

Obstetrical &Amp; Gynecological Survey

108

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Caesarean section (CS) results in the occurrence of the phenomenon 'niche'. A 'niche' describes the presence of a hypoechoic area within the myometrium of the lower uterine segment, reflecting a discontinuation of the myometrium at the site of a previous CS. Using gel or saline instillation sonohysterography, a niche is identified in the scar in more than half of the women who had had a CS, most with the uterus closed in one single layer, without closure of the peritoneum. An incompletely healed scar is a long-term complication of the CS and is associated with more gynaecological symptoms than is commonly acknowledged. Approximately 30% of women with a niche report spotting at 6-12 months after their CS. Other reported symptoms in women with a niche are dysmenorrhoea, chronic pelvic pain and dyspareunia. Given the association between a niche and gynaecological symptoms, obstetric complications and potentially with subfertility, it is important to elucidate the aetiology of niche development after CS in order to develop preventive strategies. Based on current published data and our observations during sonographic, hysteroscopic and laparoscopic evaluations of niches we postulate some hypotheses on niche development. Possible factors that could play a role in niche development include a very low incision through cervical tissue, inadequate suturing technique during closure of the uterine scar, surgical interventions that increase adhesion formation or patient-related factors that impair wound healing or increase inflammation or adhesion formation.

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Section: Introductionmentioning

confidence: 99%

Why Do Niches Develop in Caesarean Uterine Scars? Hypotheses on the Aetiology of Niche Development

Vervoort

Uittenbogaard

Hehenkamp

et al. 2016

Obstetrical &Amp; Gynecological Survey

108

View full text Add to dashboard Cite

show abstract

“…Bei der heute üblichen transversalen islhmischen Inzision der Sectio caesarea entstehen bei mindestens 6 Monate post partum vorgenom mener HS typische Bilder, deren statistische Verteilung von der Operationstechnik abhängig ist, indem die radiologisch und auch klinisch besten Resultate bei Anlegung von Einzelknopfnähten in der ersten M uskelnaht zu finden sind [3,6,9,11,12].…”

Section: Röntgenologische Veränderungen Nach Sterilitäts-und Schwangeunclassified

Röntgenologische Veränderungen nach sterilitäts- und schwangerschaftsbedingten Eingriffen an Uterus und Tuben

W¹

1966

Gynecol Obstet Invest

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“…Endometriosis is mentioned by ASPLUND (1952) as a possible explanation of similar 'duct like projections' found in the isthmic region of women who have been sub jected to repeated abrasions. Granuloma as a cause of a filling defect was demonstrated by POIDEVIN (1961). The remaining hysterographic changes have not been correlated to the morbid anatomy.…”

mentioning

confidence: 99%

“…Fistulae, evidenced by an escape of contrast medium through the scar into the parametrial or retrovesical space (POIDEVIN 1961, FOUKAS 1962, WANIOREK 1963, DURKAN 1964.…”

mentioning

confidence: 99%