{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:23:21Z","timestamp":1792113801909,"version":"4.4.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,6,20]],"date-time":"2020-06-20T00:00:00Z","timestamp":1592611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The disruption or defect of the myometrium in the uterine scar of a cesarean section (CS) has been known by various names, such as uterine niche, isthmocele, deficient uterine scar, scar pouch, or diverticulum. Symptomatology, risk factors for niche development, and available treatment modalities have been recently studied. However, the histologic features of this disease remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The histologic features of eight uterine niches are thoroughly described and a summary of the most important aspects of the uterine niche literature is provided. Five cases of CS scars without niche formation are comparatively examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most uterine niches harbor endocervical mucosa, often cystically dilated and\/or an atrophic or disorganized endometrial mucosa of lower uterine segment origin. Regenerative epithelial atypia and fibroblastic stromal reaction are frequent features. No granulomatous reaction, important inflammation, or hemorrhage is seen. CS scars without niche formation do not harbor endocervical mucosa or inclusion cysts, fibroblastic stroma, or regenerative atypia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>As more prospective studies of uterine niche development and treatment will be conducted, a detailed pathologic report with the criteria proposed herein can be designed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqaa080","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T15:09:21Z","timestamp":1587654561000},"page":"645-655","source":"Crossref","is-referenced-by-count":51,"title":["Histologic Findings of Uterine Niches"],"prefix":"10.1093","volume":"154","author":[{"given":"Georgia","family":"Karpathiou","sequence":"first","affiliation":[{"name":"Pathology Department, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine","family":"Chauleur","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department, University Hospital of Saint-Etienne, Saint-Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maroa","family":"Dridi","sequence":"additional","affiliation":[{"name":"Pathology Department, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Baillard","sequence":"additional","affiliation":[{"name":"Pathology Department, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Corsini","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department, University Hospital of Saint-Etienne, Saint-Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Marc","family":"Dumollard","sequence":"additional","affiliation":[{"name":"Pathology Department, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Peoc\u2019h","sequence":"additional","affiliation":[{"name":"Pathology Department, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,20]]},"reference":[{"key":"2020101312543986900_CIT0001","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."},{"key":"2020101312543986900_CIT0002","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jmig.2014.09.011","article-title":"Hysteroscopic treatment of symptomatic cesarean-induced isthmocele: a prospective study","volume":"22","author":"Raimondo","year":"2015","journal-title":"J Minim Invasive Gynecol."},{"key":"2020101312543986900_CIT0003","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1111\/aogs.13623","article-title":"Niche definition and guidance for detailed niche evaluation","volume":"98","author":"Jordans","year":"2019","journal-title":"Acta Obstet Gynecol Scand."},{"key":"2020101312543986900_CIT0004","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1159\/000478046","article-title":"Changes in the uterine scar during the first year after a caesarean section: a prospective longitudinal study","volume":"83","author":"van der Voet","year":"2018","journal-title":"Gynecol Obstet Invest."},{"key":"2020101312543986900_CIT0005","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jmig.2019.03.001","article-title":"Clinical success rate of extensive hysteroscopic cesarean scar defect excision and correlation to histologic findings","volume":"27","author":"Shapira","year":"2020","journal-title":"J Minim Invasive Gynecol."},{"key":"2020101312543986900_CIT0006","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."},{"key":"2020101312543986900_CIT0007","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ejogrb.2017.05.004","article-title":"Niches after cesarean section in a population seeking hysteroscopic sterilization","volume":"214","author":"van der Voet","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"2020101312543986900_CIT0008","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/1471-0528.14733","article-title":"Hysteroscopic resection of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial","volume":"125","author":"Vervoort","year":"2018","journal-title":"BJOG."},{"key":"2020101312543986900_CIT0009","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s12905-015-0260-8","article-title":"The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial","volume":"15","author":"Vervoort","year":"2015","journal-title":"BMC Womens Health."},{"key":"2020101312543986900_CIT0010","first-page":"2695","article-title":"Why do niches develop in caesarean uterine scars? 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