Prevalence of Uterine Niche Following Caesarean Section: A Hospital-Based Study

The rate of cesarean section (CS) deliveries is on the rise globally, currently accounting for over one-fifth (21%) of all childbirths. A niche is mainly a sonographic finding and has been defined as a triangular anechoic area at the presumed site of incision. This work aimed to estimate the prevalence rate of CS niche among women who underwent their CS.Methods: This prospective cohort study was carried out on 350 pregnant women admitted for CS either elective or selective. Participants were invited to a medical examination 6 months postoperatively, in which a 3D transvaginal ultrasonography (3D-TVUS) was performed to assess scar position and integrity after their CSs.Results: 67.4% of the studied women reported presence of niche during sonographic follow up within 6 months of delivery compared to 32.6% who showed no detected niche. The mean age of women without detected niche was significantly lower than those with detected niche (P<0.05). Moreover, participants without detected niche had lower mean previous C.S number compared to participants with detected niche (P <0.05). It was found that the majority of the studied women with detected niche were had repeated C.S, while the majority of women with no detected niche had C.S due to primary causes (P<0.05). Conclusions: One of the most common long-term complications is the uterine niche, which had a prevalence of 67.4% in our study according to the European Task Force definition. This definition may require revision and broader application to ensure accurate detection of the niche.