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Caesarean Section Scar Niche || Ultrasound || Case 297

Clinical Features:
A 28yearold female patient with the history of previous two caesarean sections came for a folliculometry with a desire to conceive.

Ultrasound Features:
Semicircular & triangular myometrial defects & tethering of the endometrium are seen in the lower uterine segment at the region of the old cesarean scar.

Remember:
A niche has been described as the indentation of myometrium of at least 2mm due to tethering of the endometrium.
Due to tethering of the endometrium, blood accumulates in a niche and may serve as a source of dysfunctional uterine bleeding, accounting for spotting 212 days after the routine menstrual cycle.

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