14008: C-Section Scar Ectopic and Niche Evaluation and Management

Saturday, November 14, 2026
10:15 am - 12:15 pm

Room: 311

Chair: Judith Huirne

Co-Chair: Ally Murji

Faculty: Sven Becker, Lacey C. Brennan, Robert A. de Leeuw

Description: Cesarean scar niche (isthmocele) and cesarean scar ectopic pregnancy, are increasingly encountered in gynecologic and reproductive practice. However, variability remains in their diagnosis, clinical significance, patient counselling, and management. This interactive, case-based course will provide a practical and evidence-based approach to evaluating and managing cesarean scar disorders. Faculty will review standardized diagnosis and imaging, explore management of patients presenting with abnormal uterine bleeding, pain, infertility, or an asymptomatic niche, and discuss considerations prior to embryo transfer and future pregnancy. Through clinical cases and surgical video, participants will learn how to select appropriate candidates for expectant, medical, hysteroscopic, and laparoscopic management and review key surgical techniques for niche repair. The course will conclude with a practical approach to the diagnosis and management of cesarean scar ectopic pregnancy.

Learning Objectives: At the endo of this course, the participant will be able to: 1) Diagnose and characterize cesarean scar niche and pregnancy using standardized clinical and imaging criteria; 2) Develop an individualized, evidence-based management plan for cesarean scar niche based on clinical presentation, niche characteristics, residual myometrial thickness, fertility and pregnancy goals, and patient preferences; and 3) Apply tips and tricks for surgical management of cesarean scar niche and pregnancy.

Course Outline

10:15 AM Welcome, Introduction and Course Overview
J. Huirne and A. Murji

10:20 AM Overview of Cesarean Scar Niche: Diagnosis and Classification
R. de Leeuw

10:35 am Evidence-Based Management of Cesarean Scar Niche
J. Huirne

10:50 AM Predisposing Factors and Prevention Strategies of Cesarean Scar Niche
S. Becker

11:05 AM How to Counsel Patients? Interactive Case-Based Discussion and Evidence Review
R. de Leeuw, and A. Murji

11:20 AM Surgical Tips and Tricks for Niche Repair: Hysteroscopic and Laparoscopic Approaches
L. Brennan

11:40 AM Implementation and Standardization of Diagnosis and Treatment of Niche Disorders
J. Huirne

11:50 AM Cesarean Scar Ectopic Pregnancy: Diagnosis and Management
A. Murji

12:05 PM Discussion Questions & Answers

12:15 PM Adjourn