Pregnancy following cesarean scar defect (niche) repair: a cohort study

Abstract

Purpose: The aim of the study is to learn the obstetrical outcome of women after laparoscopic niche repair.

Methods: A retrospective cohort study including all women after laparoscopic niche repair done by a single high-skilled surgeon, from July 2014 to March 2019. Data were collected from women's medical records and a telephone interview was performed to assess further symptoms and attempts to conceive, including pregnancy outcomes.

Results: During the study period, 48 women underwent laparoscopic niche repair, of them complete follow-up was achieved for 37 (78.7%) women. The median residual myometrial thickness measured by ultrasound before the repair was 2.0 mm (IQR 1.4-2.5). Attempts to conceive were reported by 81% (n = 30) of the women, while 18 (60%) achieved pregnancy in median time of 6 month (IQR 5-12) post-niche repair. 14 (78%) of the women conceived spontaneously. No placental abnormalities were reported in any of the women. All gave birth by cesarean delivery at a median of 38.4 gestation week (IQR 37.0-39.5). No dehiscence or rupture was reported.

Conclusions: Pregnancy following niche repair can be achieved with low pregnancy complication rate and good pregnancy outcomes. Further studies need to be done to strengthen our findings.

Keywords: Cesarean scar defect repair; Niche; Pregnancy outcome.