ArticleActa obstetricia et gynecologica Scandinavica2023
Reproductive outcomes after laparoscopic resection of symptomatic niches in uterine cesarean scars: Long-term follow-up on the prospective LAPNICHE study.
Article in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- High live birth rates after laparoscopic isthmocele repair in infertility: a systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Uterine cesarean scar resection during repeat cesarean delivery to prevent uterine niche formation: a randomized controlled trial.BMC pregnancy and childbirth · 2026Trial
- Cesarean Scar Defect (Isthmocele) and Secondary Infertility: A Systematic Review of Reproductive Significance.Cureus · 2026Review
- Early Postpartum Sonographic Assessment of the Uterotomy After Successful Vaginal Birth After Caesarean Section: An Observational Cohort Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Mesh closure of a protruding caesarean scar pregnancy in the 11th week of pregnancy.BMC pregnancy and childbirth · 2026Article
- Surgical Treatment Options and the Subtypes of Cesarean Scar Pregnancy Did Not Affect the Probability of a Subsequent Pregnancy: A Prospective Cohort Study.Health science reports · 2026Article
- Reproductive outcomes following assisted reproductive technology after previous caesarean section: data from the Swiss National Registry.Frontiers in endocrinology · 2026Article
- Comparison of long-term clinical effect and re-pregnant outcomes between hysteroscopic resection and laparoscopic defect repair in patients with non-severe cesarean scar defect: a retrospective study.BMC pregnancy and childbirth · 2025Article
- Impact of caesarean scar defects on the success of assisted human reproduction: the NICHE-ART prospective French cohort study protocol.BMJ open · 2024Article
- Reproductive outcomes after laparoscopic resection of symptomatic niches in uterine cesarean scars: Long-term follow-up on the prospective LAPNICHE study.Acta obstetricia et gynecologica Scandinavica · 2023Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAfter incomplete healing of the uterine cesarean section scar, a niche can be observed; 24% of the women develop large niches with a residual myometrial thickness <3 mm. In these cases a laparoscopic resection is possible. The effect of this new treatment on fertility outcome is not known yet. This paper describes reproductive outcomes 2 years after a laparoscopic niche resection and compares women with or without secondary infertility at baseline. MATERIAL AND
methodsA prospective cohort study was performed, with consecutive inclusion of women between 2011 and 2019. Women with a niche in the uterine cesarean scar, with a residual myometrial thickness of <3 mm and with a desire to become pregnant, were scheduled to undergo a laparoscopic niche resection because of one or more of the following problems (1) postmenstrual spotting; (2) midcycle intrauterine fluid accumulation diagnosed during the fertility workup or (3) difficulties with a previous embryo transfer and preferring a surgical therapy. The study is registered in the ISRCTN register (ref. no. ISRCTN02271575) on April 23, 2013.
resultsThere were 133 (62%) women included with a desire to become pregnant, 88 with secondary infertility. In all, 83 had an ongoing pregnancy at the 2-year follow-up. The ongoing pregnancy rate in patients with previous fertility problems was 60.2% compared with 66.7% in patients without infertility (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.32-1.7). The OR for live births was 0.57 (95% CI 0.02-1.2). Overall, 8.3% of the pregnancies resulted in miscarriages by the 2-year follow-up.
conclusionsThe reproductive outcomes in women with and without previous fertility problems undergoing resection of a large niche are very promising and quite comparable in both groups. These results suggest, but do not prove, a beneficial effect of this therapy for these indications. The results support the design of future randomized controlled trials to evaluate the effect of niche resection vs expectant management to assess its additional value in women with or without fertility problems who desire pregnancy.
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