Diagnosis and Management of Caesarian Section Scar Niche:Review Article | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 226, Volume 91, Issue 1, April 2023, Page 5219-5223 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2023.304052 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ashraf Talaat Abdel Fattah; Hala El-Sayed Mohamed Mowafy; Najia Abdelali Moussa; Ahmed Ismail Mohamed | ||||
| Abstract | ||||
| An isthmocele, also known any indentation that indicates myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall with the base linked to the uterine cavity at the site of a previous cesarean section scar is referred to as a cesarean scar defect or uterine niche. Myometrial flaws are classified as little or large based on the thickness of their wall. Although it usually has no symptoms, abnormal or postmenstrual bleeding is the predominant sign, and it can also result in chronic pelvic pain. Infertility, Complications of this condition include placenta accrete or previa, scar dehiscence, uterine rupture, and cesarean scar ectopic pregnancy. Numerous cesarean sections and a retroflexed uterus are known risk factors for isthmocele. Other factors, such as a lower cesarean position, partial hysterotomy closure, early uterine wall adhesions, and a genetic predisposition, may also contribute to the formation of a niche. Because there are no recognized criteria for diagnosing an isthmocele, a range of imaging techniques can be used to test the uterine wall's strength and identify an isthmocele. However, saline infusion sonohysterography and transvaginal ultrasonography stand out as precise, accurate, and cost-effective methods of isthmocele diagnosis. Clinical or surgical care may be required as part of the treatment, depends on the severity of the problem, the presence of symptoms, the presence of secondary infertility, and the desire to conceive. Depending on the size of the lesion, surgical therapy may include minimally invasive operations using sparing techniques such as hysteroscopic, laparoscopic, or transvaginal procedures. | ||||
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