{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:59:49Z","timestamp":1791835189813,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,4,2]],"date-time":"2014-04-02T00:00:00Z","timestamp":1396396800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\n                        To review systematically the medical literature reporting on the prevalence of a niche at the site of a Cesarean section (\n                        <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n                        ) scar using various diagnostic methods, on potential risk factors for the development of a niche and on niche\u2010related gynecological symptoms in non\u2010pregnant women\n                      <\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\n                        The\n                        <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>\n                        and\n                        <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                        databases were searched. All types of clinical study reporting on the prevalence, risk factors and\/or symptoms of a niche in non\u2010pregnant women with a history of\n                        <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n                        were included, apart from case reports and case series\n                      <\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\n                        Twenty\u2010one papers were selected for inclusion in the review. A wide range in the prevalence of a niche was found. Using contrast\u2010enhanced sonohysterography in a random population of women with a history of\n                        <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n                        , the prevalence was found to vary between 56% and 84%. Nine studies reported on risk factors and each study evaluated different factors, which made it difficult to compare studies. Risk factors could be classified into four categories: those related to closure technique, to development of the lower uterine segment or location of the incision or to wound healing, and miscellaneous factors. Probable risk factors are single\u2010layer myometrium closure, multiple\n                        <jats:styled-content style=\"fixed-case\">CSs<\/jats:styled-content>\n                        and uterine retroflexion. Six out of eight studies that evaluated niche\u2010related symptoms described an association between the presence of a niche and postmenstrual spotting\n                      <\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>The reported prevalence of a niche in non\u2010pregnant women varies depending on the method of detection, the criteria used to define a niche and the study population. Potential risk factors can be categorized into four main categories, which may be useful for future research and meta\u2010analyses. The predominant symptom associated with a niche is postmenstrual spotting. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.13199","type":"journal-article","created":{"date-parts":[[2013,8,30]],"date-time":"2013-08-30T11:33:06Z","timestamp":1377862386000},"page":"372-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":353,"title":["Prevalence, potential risk factors for development and symptoms related to the presence of uterine niches following Cesarean section: systematic review"],"prefix":"10.1002","volume":"43","author":[{"given":"A. J. M.","family":"Bij de Vaate","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. F.","family":"van der Voet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Deventer Hospital Deventer The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Naji","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit Queen Charlotte's and Chelsea Hospital, Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Witmer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Veersema","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology St Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. A. M.","family":"Br\u00f6lmann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bourne","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit Queen Charlotte's and Chelsea Hospital, Imperial College London UK"},{"name":"Department of Obstetrics and Gynaecology University Hospitals Katholieke Universiteit Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A. F.","family":"Huirne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2007.00786.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-200204000-00011"},{"key":"e_1_2_6_4_1","first-page":"89","article-title":"Placenta previa\/accreta and prior Cesarean section","volume":"66","author":"Clark SL","year":"1985","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200301000-00014"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8864"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2003.22.7.695"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.999"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2001.20.10.1105"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6395"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6405"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5200"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2916"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2010.02.007"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(90)90166-A"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000091497"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mefs.2010.07.015"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7496"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1999.18.1.13"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-25"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02631.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2012.01872.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12376"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340500430436"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.03.023"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.11.038"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2011.577252"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.09.004"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10077"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.13199","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.13199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:03:33Z","timestamp":1696464213000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.13199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1002\/uog.13199"],"URL":"https:\/\/doi.org\/10.1002\/uog.13199","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4]]},"assertion":[{"value":"2013-05-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-08-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-04-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}