What is a niche (niche scar)?
It is a defect (erosion or thinning) in the uterine wall that occurs after a cesarean section, whether it’s a traditional C-section, an emergency one due to complications during labor, or other reasons. There are many types and techniques of cesarean deliveries. A patient might be in the hands of a skilled surgeon who performs the procedure carefully and stitches the uterus layer by layer in the proper way. Alternatively, the cesarean could be done hastily or improperly, leading to complications such as bleeding or stretching in the lower segment of the uterus.
Other issues may also arise, such as uterine thinning due to the removal of fibroids or similar conditions. Like other surgical procedures, a cesarean may pass without complications, or it may lead to significant short- or long-term problems. In some cases, symptoms caused by a uterine niche might even be misdiagnosed as endometriosis.
This highlights the importance of raising awareness about the niche, especially as the global rate of cesarean sections has increased dramatically—reaching nearly 70% in some areas. This rise is due to multiple factors such as advancements in medical technology, scheduling convenience, or the need to save the baby during complicated deliveries. As a result, the increase in cesarean deliveries correlates with a rise in the incidence of uterine niches, which range from 6.9% to 69%. This wide variation reflects a general lack of awareness and understanding of the condition within the community.