{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T06:33:40Z","timestamp":1792305220542,"version":"4.4.0"},"reference-count":25,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100024017","name":"Sheba Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024017","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","rbmojournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Reproductive BioMedicine Online"],"published-print":{"date-parts":[[2023,8]]},"DOI":"10.1016\/j.rbmo.2023.04.012","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T02:28:48Z","timestamp":1682476128000},"page":"103221","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":28,"title":["The association between uterine scar defect (niche) and the presence of symptoms"],"prefix":"10.1016","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9818-3041","authenticated-orcid":false,"given":"Aya","family":"Mohr-Sasson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"Dadon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Brandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Shats","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Axcelrod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raanan","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Zajicek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jigal","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Mashiach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.rbmo.2023.04.012_bib0001","doi-asserted-by":"crossref","unstructured":"(2013). \u201cACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women.\u201d Obstet Gynecol 121(4): 891\u2013896.","DOI":"10.1097\/01.AOG.0000428646.67925.9a"},{"key":"10.1016\/j.rbmo.2023.04.012_bib0002","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.ejogrb.2019.11.021","article-title":"Association of cesarean scar defect with abnormal uterine bleeding: The results of a prospective study","volume":"244","author":"Antila","year":"2020","journal-title":"Eur. J. Obstet Gynecol Reprod Biol."},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0003","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/uog.8864","article-title":"Ultrasound evaluation of the Cesarean scar: relation between a niche and postmenstrual spotting","volume":"37","author":"Bij de Vaate","year":"2011","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"4","key":"10.1016\/j.rbmo.2023.04.012_bib0004","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/uog.13199","article-title":"Prevalence, potential risk factors for development and symptoms related to the presence of uterine niches following Cesarean section: systematic review","volume":"43","author":"Bij de Vaate","year":"2014","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"8","key":"10.1016\/j.rbmo.2023.04.012_bib0005","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1093\/humrep\/deh314","article-title":"Investigation of the infertile couple: when is the appropriate time to explore female infertility?","volume":"19","author":"Brosens","year":"2004","journal-title":"Hum Reprod"},{"key":"10.1016\/j.rbmo.2023.04.012_bib0006","article-title":"Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine-device use","volume":"8","author":"Christelle","year":"2022","journal-title":"Cochrane Database Syst. Rev."},{"key":"10.1016\/j.rbmo.2023.04.012_bib0007","first-page":"1","article-title":"Caesarean section operation is not associated with myometrial hypertrophy-a prospective cohort study","author":"Ewies","year":"2022","journal-title":"J. Obstet Gynaecol"},{"key":"10.1016\/j.rbmo.2023.04.012_bib0008","unstructured":"Feingold, K. R., B. Anawalt, A. Boyce, G. Chrousos, W. W. de Herder, K. Dhatariya, K. Dungan, J. M. Hershman, J. Hofland, S. Kalra, G. Kaltsas, C. Koch, P. Kopp, M. Korbonits, C. S. Kovacs, W. Kuohung, B. Laferr\u00e8re, M. Levy, E. A. McGee, R. McLachlan, J. E. Morley, M. New, J. Purnell, R. Sahay, F. Singer, M. A. Sperling, C. A. Stratakis, D. L. Trence and D. P. Wilson (2000). Endotext."},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0009","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s12884-022-04471-y","article-title":"Bacterial colonization at caesarean section defects in women of secondary infertility: an observational study","volume":"22","author":"Hsu","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0010","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/uog.19049","article-title":"Sonographic examination of uterine niche in non-pregnant women: a modified Delphi procedure","volume":"53","author":"Jordans","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"5","key":"10.1016\/j.rbmo.2023.04.012_bib0011","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1590\/1806-9282.65.5.714","article-title":"Isthmocele: an overview of diagnosis and treatment","volume":"65","author":"Kremer","year":"2019","journal-title":"Rev. Assoc. Med. Bras."},{"issue":"6","key":"10.1016\/j.rbmo.2023.04.012_bib0012","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1007\/s13224-020-01370-0","article-title":"Post-caesarean Niche (Isthmocele) in Uterine Scar: An Update","volume":"70","author":"Kulshrestha","year":"2020","journal-title":"J. Obstet Gynaecol India"},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0013","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/00004347-199501000-00004","article-title":"Surgical pathology of the lower uterine segment caesarean section scar: is the scar a source of clinical symptoms?","volume":"14","author":"Morris","year":"1995","journal-title":"Int. J. Gynecol Pathol"},{"issue":"3","key":"10.1016\/j.rbmo.2023.04.012_bib0014","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/uog.10077","article-title":"Standardized approach for imaging and measuring Cesarean section scars using ultrasonography","volume":"39","author":"Naji","year":"2012","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"10.1016\/j.rbmo.2023.04.012_bib0015","article-title":"Improvement of symptoms after hysteroscopic isthmoplasty in women with abnormal uterine bleeding and expected pregnancy: A prospective study","volume":"51","author":"Nguyen","year":"2022","journal-title":"J. Gynecol Obstet Hum Reprod"},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0016","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/uog.7496","article-title":"Cesarean section scar defects: agreement between transvaginal sonographic findings with and without saline contrast enhancement","volume":"35","author":"Osser","year":"2010","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"10.1016\/j.rbmo.2023.04.012_bib0017","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/uog.999","article-title":"Cesarean section scar evaluation by saline contrast sonohysterography","volume":"23","author":"Regnard","year":"2004","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"6","key":"10.1016\/j.rbmo.2023.04.012_bib0018","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1055\/s-0032-1304829","article-title":"Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterine scar defect","volume":"29","author":"Roberge","year":"2012","journal-title":"Am. J. Perinatol"},{"issue":"3","key":"10.1016\/j.rbmo.2023.04.012_bib0019","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1055\/s-0041-1736393","article-title":"Uterine Isthmocele-A Frequently Overlooked Complication of Cesarean Sections","volume":"31","author":"Rupa","year":"2021","journal-title":"Indian J. Radiol Imaging"},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0020","doi-asserted-by":"crossref","first-page":"13","DOI":"10.7863\/jum.1999.18.1.13","article-title":"Cesarean section scar as a cause of abnormal vaginal bleeding: diagnosis by sonohysterography","volume":"18","author":"Thurmond","year":"1999","journal-title":"J. Ultrasound Med."},{"issue":"6","key":"10.1016\/j.rbmo.2023.04.012_bib0021","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.jmig.2016.06.020","article-title":"Emerging Manifestations of Cesarean Scar Defect in Reproductive-aged Women","volume":"23","author":"Tulandi","year":"2016","journal-title":"J. Minim Invasive Gynecol"},{"issue":"4","key":"10.1016\/j.rbmo.2023.04.012_bib0022","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1097\/AOG.0b013e3181d4891e","article-title":"Fertility and uterine artery embolization","volume":"115","author":"Tulandi","year":"2010","journal-title":"Obstet Gynecol"},{"issue":"2","key":"10.1016\/j.rbmo.2023.04.012_bib0023","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/1471-0528.12542","article-title":"Long-term complications of caesarean section. The niche in the scar: a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding","volume":"121","author":"van der Voet","year":"2014","journal-title":"BJOG"},{"issue":"1","key":"10.1016\/j.rbmo.2023.04.012_bib0024","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1002\/uog.6405","article-title":"Cesarean scar defect: correlation between Cesarean section number, defect size, clinical symptoms and uterine position","volume":"34","author":"Wang","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"7","key":"10.1016\/j.rbmo.2023.04.012_bib0025","first-page":"435","article-title":"Abnormal Uterine Bleeding in Premenopausal Women","volume":"99","author":"Wouk","year":"2019","journal-title":"Am. Fam. Physician"}],"container-title":["Reproductive BioMedicine Online"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1472648323002638?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1472648323002638?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T08:25:38Z","timestamp":1761467138000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1472648323002638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["S1472648323002638"],"URL":"https:\/\/doi.org\/10.1016\/j.rbmo.2023.04.012","relation":{},"ISSN":["1472-6483"],"issn-type":[{"value":"1472-6483","type":"print"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The association between uterine scar defect (niche) and the presence of symptoms","name":"articletitle","label":"Article Title"},{"value":"Reproductive BioMedicine Online","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.rbmo.2023.04.012","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"103221"}}