{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T21:32:01Z","timestamp":1794432721668,"version":"4.9.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T00:00:00Z","timestamp":1546387200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To generate guidance for detailed uterine niche evaluation by ultrasonography in the non\u2010pregnant woman, using a modified Delphi procedure amongst European experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty gynecological experts were approached through their membership of the European Niche Taskforce. All experts were physicians with extensive experience in niche evaluation in clinical practice and\/or authors of niche publications. By means of a modified Delphi procedure, relevant items for niche measurement were determined based on the results of a literature search and recommendations of a focus group of six Dutch experts. It was predetermined that at least three Delphi rounds would be performed (two online questionnaires completed by the expert panel and one group meeting). For it to be declared that consensus had been reached, a consensus rate for each item of at least 70% was predefined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen experts participated in the Delphi procedure.  Consensus was reached for all 42 items on niche evaluation, including definitions, relevance, method of measurement and tips for visualization of the niche. A niche was defined as an indentation at the site of a Cesarean section with a depth of at least 2 mm. Basic measurements, including niche length and depth, residual and adjacent myometrial thickness in the sagittal plane, and niche width in the transverse plane, were considered to be essential. If present, branches should be reported and additional measurements should be made. The use of gel or saline contrast sonography was preferred over standard transvaginal sonography but was not considered mandatory if intrauterine fluid was present. Variation in pressure generated by the transvaginal probe can facilitate imaging, and Doppler imaging can be used to differentiate between a niche and other uterine abnormalities, but neither was considered mandatory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Consensus between niche experts was achieved regarding ultrasonographic niche evaluation. \u00a9 2018 The Authors.\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.19049","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T07:51:18Z","timestamp":1521100278000},"page":"107-115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":283,"title":["Sonographic examination of uterine niche in non\u2010pregnant women: a modified Delphi procedure"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-7263","authenticated-orcid":false,"given":"I. P. M.","family":"Jordans","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Cardiovascular Sciences VU Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"de Leeuw","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Cardiovascular Sciences VU Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1353-5576","authenticated-orcid":false,"given":"S. I.","family":"Stegwee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Cardiovascular Sciences VU Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. N.","family":"Amso","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. N.","family":"Barri\u2010Soldevila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitari Dexeus  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"van den Bosch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bourne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. A. M.","family":"Br\u00f6lmann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Cardiovascular Sciences VU Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Donnez","sequence":"additional","affiliation":[{"name":"Institut du sien et de Chirurgie Gyn\u00e9cologique d'Avignon Polyclinique Urbain V (Elsan Group)  Avignon France"},{"name":"Institut de Recherche Experimentale et Clinique Universit\u00e9 Catholique de Louvain  Bruxelles Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2577-7903","authenticated-orcid":false,"given":"M.","family":"Dueholm","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. J. K.","family":"Hehenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Cardiovascular Sciences VU Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Jastrow","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology H\u00f4pitaux Universitaires de Gen\u00e8ve, Gen\u00e8ve  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6487-5736","authenticated-orcid":false,"given":"D.","family":"Jurkovic","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mashiach","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Naji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Streuli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology H\u00f4pitaux Universitaires de Gen\u00e8ve, Gen\u00e8ve  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Timmerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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