{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T20:22:47Z","timestamp":1773174167875,"version":"3.50.1"},"reference-count":17,"publisher":"Galenos Yayinevi","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facts Views Vis ObGyn"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>Background: Uterine niche is the consequence of impaired healing of the myometrium following a lower segment transverse caesarean section (CS). Although there is conflicting evidence on the management of these cases, laparoscopic repair is a commonly used surgical treatment modality.\n\nObjectives: To demonstrate the management and laparoscopic repair of the niche with subsequent pregnancy outcome.\n\nMaterials and Methods: We report a case of a 33-year-old patient who had a significant haematoma in the niche. The haematoma resolved after conservative management however, she remained symptomatic. Therefore, she had a laparoscopic repair. The narrated surgical video article demonstrates the dissection of the uterovesical fold overlying the niche, followed by the excision of the scar tissue and its repair with laparoscopic suturing. Ultrasound and magnetic resonance imaging images of the uterus demonstrating the haematoma at the caesarean section site, the niche after resolution of the haematoma and post-repair imaging are also provided.\n\nMain outcome measures: Repair of the niche, symptomatic relief of abnormal uterine bleeding, spontaneous conception and live birth. Ultrasonographic images also demonstrate uterine wall continuity post laparoscopic repair.\n\nResults: The patient recovered uneventfully. Full-thickness of myometrium was demonstrated with post-operative imaging and confirmed at the subsequent caesarean section. Gynaecological symptoms resolved following the repair. The patient conceived spontaneously after surgery and delivered at term by caesarean section without any complications.\n\nConclusion: Laparoscopic management of the niche should be considered where there is a complete myometrial defect or significant thinning of the myometrium, especially in symptomatic women who desire future pregnancy.<\/jats:p>","DOI":"10.52054\/fvvo.13.4.038","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T00:17:31Z","timestamp":1642119451000},"page":"411-414","source":"Crossref","is-referenced-by-count":3,"title":["Laparoscopic management of a full-thickness uterine niche with subsequent pregnancy outcome"],"prefix":"10.52054","volume":"13","author":[{"given":"D.Z.","family":"Kasapoglu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.Y.O.","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.A.","family":"Kadir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Shakir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2811","published-online":{"date-parts":[[2022,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Antila-L\u00e5ngsj\u00f6 RM, M\u00e4enp\u00e4\u00e4 JU, Huhtala HS et al. Cesarean scar defect: a prospective study on risk factors. Am J Obstet Gynecol. 2018:458.","DOI":"10.1016\/j.ajog.2018.09.004"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Betr\u00e1n AP, Ye J, Moller AB et al. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS one. 2016.","DOI":"10.1371\/journal.pone.0148343"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Bij de Vaate, A., H. Br\u00f6lmann, L. Van Der Voet et al. Ultrasound evaluation of the Cesarean scar: relation between a niche and postmenstrual spotting. Ultrasound Obstet Gynecol. 2011: 93-9.","DOI":"10.1002\/uog.8864"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Bij de Vaate A, Van der Voet L, Naji O et al. Prevalence, potential risk factors for development and symptoms related to the presence of uterine niches following Cesarean section: systematic review. Ultrasound Obstet Gynecol. 2014:372-82.","DOI":"10.1002\/uog.13199"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Brook AJ, Clarke FR, Bhatia K. Gynaecological morbidity associated with caesarean niche: increasing awareness, prevention and management. Obstet Gynaecol. 2020: 122-30.","DOI":"10.1111\/tog.12642"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Jordans I, De Leeuw R, Stegwee S et al. Sonographic examination of uterine niche in non-pregnant women: a modified Delphi procedure. Ultrasound Obstet Gynecol. 2019:107-15.","DOI":"10.1002\/uog.19049"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Morris, H. Surgical pathology of the lower uterine segment caesarean section scar: is the scar a source of clinical symptoms? Int J Gynecol Pathol. 1995;14:16-20.","DOI":"10.1097\/00004347-199501000-00004"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Naji O, Abdallah Y, Bij De Vaate A et al. Standardized approach for imaging and measuring Cesarean section scars using ultrasonography. Ultrasound Obstet Gynecol. 2012:252-9.","DOI":"10.1002\/uog.10077"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Nezhat C, Falik R, Li A. Surgical management of niche, isthmocele, uteroperitoneal fistula, or cesarean scar defect: a critical rebirth in the medical literature. Fertil Steril. 2017: 69-71.","DOI":"10.1016\/j.fertnstert.2016.10.017"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Roberge S, Boutin A, Chaillet N et al. Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterine scar defect. Am J Perinatol. 2012:465-72.","DOI":"10.1055\/s-0032-1304829"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Schepker N, Garcia-Rocha GJ, von Versen-H\u00f6ynck F et al. Clinical diagnosis and therapy of uterine scar defects after caesarean section in non-pregnant women. Arch Gynecology Obstetrics. 2015:1417-23.","DOI":"10.1007\/s00404-014-3582-0"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Tower AM, Frishman GN. Cesarean scar defects: an underrecognized cause of abnormal uterine bleeding and other gynecologic complications. J Minim Invasive Gynecol. 2013:562-72.","DOI":"10.1016\/j.jmig.2013.03.008"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Van der Voet L, Bij de Vaate A, Veersema S et al. 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. BJOG. 2014:236-44.","DOI":"10.1111\/1471-0528.12542"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Van der Voet L, Vervoort A, Veersema S et al. Minimally invasive therapy for gynaecological symptoms related to a niche in the caesarean scar: a systematic review. BJOG. 2014:145-56.","DOI":"10.1111\/1471-0528.12537"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Vervoort A, Uittenbogaard L, Hehenkamp W et al. Why do niches develop in Caesarean uterine scars? Hypotheses on the aetiology of niche development. Hum Reprod. 2015:2695.","DOI":"10.1093\/humrep\/dev240"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Vervoort A, Van der Voet L, Witmer M et al. The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial. BMC Women\u2019s Health. 2015:1-9.","DOI":"10.1186\/s12905-015-0260-8"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Vervoort A, Vissers J, Hehenkamp W et al. The effect of laparoscopic resection of large niches in the uterine caesarean scar on symptoms, ultrasound findings and quality of life: a prospective cohort study. BJOG. 2018:317-25.","DOI":"10.1111\/1471-0528.14822"}],"container-title":["Facts, Views and Vision in ObGyn"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T05:55:18Z","timestamp":1739512518000},"score":1,"resource":{"primary":{"URL":"https:\/\/fvvo.eu\/articles\/doi\/FVVO.13.4.038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,1]]},"published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.52054\/fvvo.13.4.038","relation":{},"ISSN":["2684-4230","2032-0418"],"issn-type":[{"value":"2684-4230","type":"electronic"},{"value":"2032-0418","type":"print"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}