Pregnancy Following Cesarean Scar Defect (niche) Repair

Study Objective To report pregnancy success rate and pregnancy outcome in women following cesarean scar defect (niche) repair. Design A retrospective cohort study from July 2014 to March 2019. Setting Single medical care center. Patients or Participants All women after laparoscopic niche repair done by a single high skilled surgeon, during the study period. Interventions Data was collected from women's medical records and a telephone interview was performed to assess further symptoms and attempts to conceive, including pregnancy outcomes. Measurements and Main Results During the study period 48 women underwent laparoscopic niche repair, of them complete follow-up was achieved for 37 (78.7%) women. Median age was 35 years (IQR 32-39) with median of one cesarean delivery in the past (IQR 1-1). 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 uterine dehiscence or rupture were reported. Conclusion Pregnancy following cesarean scar defect repair can be achieved with low pregnancy complication rate and good pregnancy outcomes. Further studies need to be done in order to strengthen our findings.