{
    "abstract": "To review the definitions, diagnostic methods, risk factors, symptoms, and treatments for caesarean scar niche.\nReview of the literature, critical reflection, and pragmatic advice.\nThere is no consensus on the definition of caesarean scar niche. Some suggest an indentation\u22652mm of the myometrium of the caesarean scar, but this is present in more than half of women with caesarean history and takes no account of woman's symptoms. The most popular diagnostic method is ultrasound\u00b1hysterosonography. Risks factors for niche are multiple Caesareans, Cesarean during labor with too low incision, and retroverted uterus. Symptoms include abnormal gynaecologic bleeding and pelvic pain, and their presence establish the \"Caesarean scar syndrome\". The risks of pregnancy with niche is poorly studied, but pregnancy is not contraindicated, even if the niche is untreated. The treatment of caesarean scar niche is mainly surgery and conservative. The former should be reserved for symptomatic patients, and those with secondary infertility and fertility treatment failure. Patients with residual myometrium thickness\u22652.5mm may benefit from first-line hysteroscopic treatment, whereas a laparoscopic or vaginal approach could be offered in other cases.\nA pragmatic definition of caesarean scar niche as a disease including symptoms is the necessary prerequisite for the management of women. The treatment is mainly surgical, or conservative depending on the desire for subsequent pregnancy.",
    "authors": [
        {
            "affiliation": "Division of Child Health, Obstetrics & Gynaecology, University of Nottingham, Maternity building of the City Hospital, Hucknall Road, NG5 1PB Nottingham, Royaume-Uni; Service de gyn\u00e9cologie-obst\u00e9trique, CHU de Rouen, Universit\u00e9 de Rouen, Rouen, France. Electronic address: Antoine.Torre@chu-rouen.fr.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Torre"
        },
        {
            "affiliation": "Service de gyn\u00e9cologie-obst\u00e9trique, CHU de Rouen, Universit\u00e9 de Rouen, Rouen, France.",
            "firstname": "E",
            "initials": "E",
            "lastname": "Verspyck"
        },
        {
            "affiliation": "Univ Montpellier, Inserm U1203, EmbryoPluripotency, Montpellier, France; IRMB, Univ Montpellier, Inserm, Montpellier, France; CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France.",
            "firstname": "S",
            "initials": "S",
            "lastname": "Hamamah"
        },
        {
            "affiliation": "Department of Imaging, Hopital Tenon, AP-HP, 75020 Paris, France.",
            "firstname": "I",
            "initials": "I",
            "lastname": "Thomassin"
        },
        {
            "affiliation": "Division of Child Health, Obstetrics & Gynaecology, University of Nottingham, Maternity building of the City Hospital, Hucknall Road, NG5 1PB Nottingham, Royaume-Uni.",
            "firstname": "J",
            "initials": "J",
            "lastname": "Thornton"
        },
        {
            "affiliation": "Department of Biology, Medicine and Health, Research unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Versailles St-Quentin University, Montigny-le-Bretonneux, France; Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-St Germain en Laye, Poissy, France.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Fauconnier"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Assistance Publique-H\u00f4pitaux de Marseille, La Conception Hospital, Aix Marseille Universit\u00e9, Marseille, France.",
            "firstname": "P",
            "initials": "P",
            "lastname": "Crochet"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2021 Elsevier Masson SAS. All rights reserved.",
    "doi": "10.1016/j.gofs.2021.06.003",
    "journal": "Gynecologie, obstetrique, fertilite & senologie",
    "keywords": [
        "Caesarean scar niche",
        "Definition",
        "Diagnosis",
        "Diagnostic",
        "D\u00e9finition",
        "Isthmoc\u00e8le",
        "Prevention",
        "Pr\u00e9vention",
        "Traitement",
        "Treatment"
    ],
    "methods": null,
    "publication_date": "2021-06-19",
    "pubmed_id": "34144220",
    "results": "There is no consensus on the definition of caesarean scar niche. Some suggest an indentation\u22652mm of the myometrium of the caesarean scar, but this is present in more than half of women with caesarean history and takes no account of woman's symptoms. The most popular diagnostic method is ultrasound\u00b1hysterosonography. Risks factors for niche are multiple Caesareans, Cesarean during labor with too low incision, and retroverted uterus. Symptoms include abnormal gynaecologic bleeding and pelvic pain, and their presence establish the \"Caesarean scar syndrome\". The risks of pregnancy with niche is poorly studied, but pregnancy is not contraindicated, even if the niche is untreated. The treatment of caesarean scar niche is mainly surgery and conservative. The former should be reserved for symptomatic patients, and those with secondary infertility and fertility treatment failure. Patients with residual myometrium thickness\u22652.5mm may benefit from first-line hysteroscopic treatment, whereas a laparoscopic or vaginal approach could be offered in other cases.",
    "title": "[Cesarean scare niche: Definition, diagnosis, risk factors, prevention, symptoms, adverse effects, and treatments].",
    "xml": "<Element 'PubmedArticle' at 0x788502fea0c0>"
}