TY - JOUR
T1 - Niches after cesarean section in a population seeking hysteroscopic sterilization
AU - Voet, Lucy Lucet F van der
AU - Limperg, Tobias
AU - Veersema, Sebastiaan
AU - Timmermans, Anne M.
AU - Bij de Vaate, A. Marjolein J.
AU - Brölmann, Hans A M
AU - Huirne, Judith A F
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objective To study the prevalence of hysteroscopically evaluated disruptions of the integrity of the uterine wall (‘niches’) in women with and without a previous cesarean section. Study design A prospective cohort study was performed in a teaching hospital in the Netherlands. Women seeking hysteroscopic sterilization were included. A hysteroscopic evaluation of the anterior wall of the uterus and cervix to identify the existence of disruptions (niches) was performed in a standard manner. Primary outcome was the presence of a uterine niche, defined as any visible defect, disruption, or concavity (gap) in the anterior wall. Secondary outcome was to develop a registration form of niche features for hysteroscopic evaluation. Results In total, 713 women were included, 603 without and 110 with a previous cesarean section. In women with a previous cesarean Section 83 (75%) niches were observed using hysteroscopy. Anterior wall disruptions were not observed in women without a cesarean section. The following niche features were identified and incorporated in a registration form: polyps, cysts, myometrium defect, fibrotic tissue, (abnormal) vascular pattern, lateral branches, mucus production inside the defect, and bleeding. Conclusion In a prospective cohort study among women undergoing hysteroscopic sterilization, a uterine niche could be detected by hysteroscopy in 75% of women with a previous cesarean section.
AB - Objective To study the prevalence of hysteroscopically evaluated disruptions of the integrity of the uterine wall (‘niches’) in women with and without a previous cesarean section. Study design A prospective cohort study was performed in a teaching hospital in the Netherlands. Women seeking hysteroscopic sterilization were included. A hysteroscopic evaluation of the anterior wall of the uterus and cervix to identify the existence of disruptions (niches) was performed in a standard manner. Primary outcome was the presence of a uterine niche, defined as any visible defect, disruption, or concavity (gap) in the anterior wall. Secondary outcome was to develop a registration form of niche features for hysteroscopic evaluation. Results In total, 713 women were included, 603 without and 110 with a previous cesarean section. In women with a previous cesarean Section 83 (75%) niches were observed using hysteroscopy. Anterior wall disruptions were not observed in women without a cesarean section. The following niche features were identified and incorporated in a registration form: polyps, cysts, myometrium defect, fibrotic tissue, (abnormal) vascular pattern, lateral branches, mucus production inside the defect, and bleeding. Conclusion In a prospective cohort study among women undergoing hysteroscopic sterilization, a uterine niche could be detected by hysteroscopy in 75% of women with a previous cesarean section.
KW - Cesarean section
KW - Hysteroscopy
KW - Niche
KW - Scar defect
UR - http://www.scopus.com/inward/record.url?scp=85019163203&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2017.05.004
DO - 10.1016/j.ejogrb.2017.05.004
M3 - Article
AN - SCOPUS:85019163203
SN - 0301-2115
VL - 214
SP - 104
EP - 108
JO - European Journal of Obstetrics, Gynecology and Reproductive Biology
JF - European Journal of Obstetrics, Gynecology and Reproductive Biology
ER -