In this retrospective cohort study, all women with niche who were diagnosed and treated at the Niche Sub-Specialty Clinic in the International Peace Maternity and Child Health Hospital (IPMCH) affiliated to Shanghai Jiao Tong University School of Medicine between June 2017 and June 2019 were included. Only women with the surgical history of transvaginal niche repair or hysteroscopic niche resection were included for analysis.
The inclusion criteria were as follows: (1) history of at least one CS; (2) existence of the symptom of postmenstrual spotting, defined as the presence of brown discharges for ≥2 days immediately after menstruation or intermenstrual bleeding for ≥2 days; and (3) the defect in the lower anterior uterine segment with at least a 2-mm depth by transvaginal ultrasonography (TVUS) and the residual myometrium thickness (RMT) between at least 2.2 mm. The exclusion criteria were as follows: (1) presence of abnormal menstruation before CS; (2) history of placement of a levonorgestrel intrauterine system or abnormal blood coagulation function or endocrine disease; (3) long-term use of oral contraceptives or gonadotropin-releasing hormone agonists; (4) presence of postoperative pathology-confirmed endometrial disease, such as submucosal fibroids, endometrial cancer, and abnormal endometrial hyperplasia; and (5) non-attendance for the routine outpatient visits.
In our sub-specialty clinic, all the women with niche who have received surgical or medical managements were followed by routine outpatient visits every three months for at least one year.
The inclusion criteria were as follows: (1) history of at least one CS; (2) existence of the symptom of postmenstrual spotting, defined as the presence of brown discharges for ≥2 days immediately after menstruation or intermenstrual bleeding for ≥2 days; and (3) the defect in the lower anterior uterine segment with at least a 2-mm depth by transvaginal ultrasonography (TVUS) and the residual myometrium thickness (RMT) between at least 2.2 mm. The exclusion criteria were as follows: (1) presence of abnormal menstruation before CS; (2) history of placement of a levonorgestrel intrauterine system or abnormal blood coagulation function or endocrine disease; (3) long-term use of oral contraceptives or gonadotropin-releasing hormone agonists; (4) presence of postoperative pathology-confirmed endometrial disease, such as submucosal fibroids, endometrial cancer, and abnormal endometrial hyperplasia; and (5) non-attendance for the routine outpatient visits.
In our sub-specialty clinic, all the women with niche who have received surgical or medical managements were followed by routine outpatient visits every three months for at least one year.
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