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Background <p>The Uterine niche is a common complication of lower-segment caesarean section. In recent years increasing attention has been given to the niche because of its association with various symptoms.</p> Aim and objective <p>To know the incidence, characteristics, and clinical association of Niche.</p> Methods <p>It is retrospective observational study. All non-pregnant women who underwent pelvic ultrasound with a history of caesarean section in Nishant hospital, Patna, from January 2021 to April 2025 were included in the study. Total 410 women fulfilled the criteria. Detailed history taken, Transabdominal and transvaginal ultrasonography done in all cases. Presence of Niche and its measurement was done according to Delphi consensus 2019. Shape, size, depth was evaluated. In 105 Women (25.6%) Niche was identified. Average time to onset of symptoms was 3&#xa0;year 7&#xa0;month. Mean depth of niche was 4.1&#xa0;mm. Large niche identified in 64 cases (60.9%). The most common shape was triangular and most common type was simple niche. Anteverted uterus was noted in 57 cases (54.28%) of niche. Incidence of larger niche was more common with Anteverted retroflexed uterus (24/33)-72.72% cases. The most common presenting complain in niche was chronic pelvic pain. Abnormal uterine bleeding and Dysmenorrhoea were associated with larger niche while chronic pelvic pain and subfertility were related to both small and large niche. Tranabdominal USG failed to diagnose 22 cases which were diagnosed by Transvaginal ultrasound.</p> Conclusion <p>Niche is common complication of LSCS. Size of niche may have impact on clinical symptoms. Possibility of niche must be considered in symptomatic women with history of previous caesarean section. Anteverted retroflexed uterus have higher incidence of large niche. TVS is better modality for diagnosis of Niche Further larger studies are needed to establish relationship.</p>

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Study on Incidence, Morphology and Clinical Association of Niche in Non-pregnant Women

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Aashita Shrivastava,
  • Richa Jha

摘要

Background

The Uterine niche is a common complication of lower-segment caesarean section. In recent years increasing attention has been given to the niche because of its association with various symptoms.

Aim and objective

To know the incidence, characteristics, and clinical association of Niche.

Methods

It is retrospective observational study. All non-pregnant women who underwent pelvic ultrasound with a history of caesarean section in Nishant hospital, Patna, from January 2021 to April 2025 were included in the study. Total 410 women fulfilled the criteria. Detailed history taken, Transabdominal and transvaginal ultrasonography done in all cases. Presence of Niche and its measurement was done according to Delphi consensus 2019. Shape, size, depth was evaluated. In 105 Women (25.6%) Niche was identified. Average time to onset of symptoms was 3 year 7 month. Mean depth of niche was 4.1 mm. Large niche identified in 64 cases (60.9%). The most common shape was triangular and most common type was simple niche. Anteverted uterus was noted in 57 cases (54.28%) of niche. Incidence of larger niche was more common with Anteverted retroflexed uterus (24/33)-72.72% cases. The most common presenting complain in niche was chronic pelvic pain. Abnormal uterine bleeding and Dysmenorrhoea were associated with larger niche while chronic pelvic pain and subfertility were related to both small and large niche. Tranabdominal USG failed to diagnose 22 cases which were diagnosed by Transvaginal ultrasound.

Conclusion

Niche is common complication of LSCS. Size of niche may have impact on clinical symptoms. Possibility of niche must be considered in symptomatic women with history of previous caesarean section. Anteverted retroflexed uterus have higher incidence of large niche. TVS is better modality for diagnosis of Niche Further larger studies are needed to establish relationship.