Osman Sevket1, Seda Ates2, Taner Molla2, Fulya Ozkal2, Omer Uysal3, Ramazan Dansuk2. 1. Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey. Electronic address: sevketosman@gmail.com. 2. Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey. 3. Department of Medical Statistics and Informatics, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Abstract
OBJECTIVE: To compare the effects of 2 suturing techniques (single versus double layer) on healing of the uterine scar after a cesarean delivery. METHODS: In the present randomized, prospective study, 36 women with a term pregnancy who had an elective cesarean delivery were randomly assigned to closure of the uterine incision with a single-layer locked suture or with a double-layer locked/unlocked suture. Six months after the operation, the integrity of the cesarean scar at the uterine incision site was assessed by hydrosonography. The healing ratio and the thickness of the residual myometrium covering the defect were calculated as markers of uterine scar healing. RESULTS: There were no significant differences between the groups in terms of estimated blood loss, operation time, or additional hemostatic suture. However, the mean thickness of the residual myometrium covering the defect was 9.95 ± 1.94 mm after a double-layer closure and 7.53 ± 2.54 mm after a single-layer closure (P = 0.005). The mean healing ratio was significantly higher after a double-layer closure (0.83 ± 0.10) than after a single-layer closure (0.67 ± 0.15; P = 0.004). CONCLUSION: A double-layer locked/unlocked closure of the uterine incision at cesarean delivery decreases the risk of poor uterine scar healing.
RCT Entities:
OBJECTIVE: To compare the effects of 2 suturing techniques (single versus double layer) on healing of the uterine scar after a cesarean delivery. METHODS: In the present randomized, prospective study, 36 women with a term pregnancy who had an elective cesarean delivery were randomly assigned to closure of the uterine incision with a single-layer locked suture or with a double-layer locked/unlocked suture. Six months after the operation, the integrity of the cesarean scar at the uterine incision site was assessed by hydrosonography. The healing ratio and the thickness of the residual myometrium covering the defect were calculated as markers of uterine scar healing. RESULTS: There were no significant differences between the groups in terms of estimated blood loss, operation time, or additional hemostatic suture. However, the mean thickness of the residual myometrium covering the defect was 9.95 ± 1.94 mm after a double-layer closure and 7.53 ± 2.54 mm after a single-layer closure (P = 0.005). The mean healing ratio was significantly higher after a double-layer closure (0.83 ± 0.10) than after a single-layer closure (0.67 ± 0.15; P = 0.004). CONCLUSION: A double-layer locked/unlocked closure of the uterine incision at cesarean delivery decreases the risk of poor uterine scar healing.
Authors: Aleksandra Stupak; Adrianna Kondracka; Agnieszka Fronczek; Anna Kwaśniewska Journal: Int J Environ Res Public Health Date: 2021-11-15 Impact factor: 3.390
Authors: Sanne I Stegwee; Ângela J Ben; Mohamed El Alili; Lucet F van der Voet; Christianne J M de Groot; Judith E Bosmans; Judith A F Huirne Journal: BMJ Open Date: 2021-07-02 Impact factor: 2.692
Authors: Ayman Shehata Dawood; Adel Elgergawy; Ahmed Elhalwagy; Walid M Ataallah; Shereen B Elbohoty; Shereef L Elshwaikh; Amal A Elsokary; Ahmed M Elkhyat; Amr T Elbadry; Ahmed M Abbas Journal: Int J Womens Health Date: 2019-01-10