Amsterdam University Medical Center, Location Vrije Universiteit Amsterdam, Department of Obstetrics & Gynaecology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
Amsterdam University Medical Center, Location Vrije Universiteit Amsterdam, Department of Obstetrics & Gynaecology, De Boelelaan 1117, Amsterdam, the Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2023 Aug;90:102390. doi: 10.1016/j.bpobgyn.2023.102390. Epub 2023 Jul 15.
Of all neonates, 21% are delivered by cesarean section (CS). A long-term maternal complication of an SC is a uterine niche. The aim of this review is to provide an overview of the current literature on imaging techniques and niche-related symptomatology. We performed systematic searches on imaging and niche symptoms. For both searches, 87 new studies were included. Niche evaluation by transvaginal sonography (TVS) or contrast sonohysterography (SHG) proved superior over hysteroscopy or magnetic resonance imaging. Studies that used SHG in a random population identified a niche prevalence of 42%-84%. Niche prevalence differed based on niche definition, symptomatology, and imaging technique. Most studies reported an association with gynecological symptoms, poor reproductive outcomes, obstetrical complications, and reduced quality of life. In conclusion, non-invasive TVS and SHG are the superior imaging modalities to diagnose a niche. Niches are prevalent and strongly associated with gynecological symptoms and poor reproductive outcomes.
所有新生儿中，有 21% 通过剖宫产（CS）分娩。SC 的一个长期母体并发症是子宫陷凹。本综述的目的是提供有关影像学技术和陷凹相关症状的现有文献综述。我们对影像学和陷凹症状进行了系统搜索。对于这两个搜索，共纳入了 87 项新研究。经阴道超声（TVS）或对比超声造影（SHG）评估陷凹优于宫腔镜或磁共振成像。在随机人群中使用 SHG 的研究发现，陷凹的患病率为 42%-84%。陷凹的患病率因陷凹定义、症状和影像学技术而异。大多数研究报告与妇科症状、不良生殖结局、产科并发症和生活质量下降有关。总之，非侵入性 TVS 和 SHG 是诊断陷凹的最佳影像学方法。陷凹很常见，与妇科症状和不良生殖结局密切相关。
