The global rate of caesarean sections (CS) has significantly increased in recent years, currently averaging 21%, with an expected rise to approximately 30% by 2030. A complication of a CS is the development of a niche, defined as an indentation at the site of a CS scar, with a depth of at least 2 mm. Niche formation can lead to gynaecological symptoms such as abnormal bleeding, abdominal pain, and fertility problems. The aim of this thesis was to investigate the development and prevention of a niche after a CS, along with long-term complications related to fertility and subsequent pregnancies. Additionally, the third part aimed to standardize the sonographic assessment of both a niche and a caesarean scar pregnancy (CSP).
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