{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:59:51Z","timestamp":1791835191824,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To compare the prevalence and size of residual niche in the nongravid uterus following Cesarean delivery (CD) with different hysterotomy closure techniques (HCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Saline infusion sonohysterogram (SIS) was performed in women after one prior CD, documenting the presence or absence of a postoperative niche and measuring its depth, width, length, and residual myometrial thickness. Women were grouped by HCT: Technique A (endometrium\u2010free) and Technique B (routine non\u2010endometrium\u2010free). The primary outcome was the prevalence of a clinically significant niche, defined as a depth of &gt;2\u2009mm. HCT groups were compared using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>T<\/jats:italic>\n                      \u2010test (ANOVA), and analyzed using logistic regression and two\u2010sided test (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five women had SIS performed, 25 and 20 via Technique A and B, respectively. Technique groups varied by average interval time from CD to SIS (13.6 versus 74.5\u2009months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.006) but were otherwise similar. Twenty niches were diagnosed, 85% of which were clinically significant, including five following Technique A, nine following Technique B with double\u2010layer closure, and three following Technique B with single\u2010layer (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.018). The average niche depth was 2.4\u2009mm and 4.9\u2009mm among the two\u2010layer subgroups following Techniques A and B, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.005). A clinically significant niche development was six times higher with Technique B when compared to Technique A (OR 6.0, 95% CI 1.6\u201322.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.008); this significance persisted after controlling for SIS interval on multivariate analysis (OR 4.4, 95% CI 1.1\u201318.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.04). The average niche depth was 5.7\u2009\u00b1\u20092.9\u2009mm following Technique B with single\u2010layer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Hysterotomy closure techniques determine the prevalence of post\u2010Cesarean delivery niche formation and size. Exclusion of the endometrium at uterine closure reduces the development of significant scar defects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.15859","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T15:46:59Z","timestamp":1635868019000},"page":"1763-1771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["The Impact of Uterine Incision Closure Techniques on Post\u2010cesarean Delivery Niche Formation and Size"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-8524","authenticated-orcid":false,"given":"Clarel","family":"Antoine","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna S.","family":"Silverstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jameshisa","family":"Alexander","sequence":"additional","affiliation":[{"name":"Compassionate Obstetrics and Gynaecology Care PLLC  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheongeun","family":"Oh","sequence":"additional","affiliation":[{"name":"Biostatistics, Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan E.","family":"Timor\u2010Tritsch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2001.20.10.1105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2015.09.015"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.326125516"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2019.05.013"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318209abf0"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8864"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.04.026"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.03.026"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12542"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.09.004"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20184"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19049"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13199"},{"key":"e_1_2_9_15_1","first-page":"2695","article-title":"Why do niches develop in caesarean uterine scars? 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