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Hydrosonographic assessment of the effects of 2 different suturing techniques on healing of the uterine scar after cesarean delivery
Author(s) -
Sevket Osman,
Ates Seda,
Molla Taner,
Ozkal Fulya,
Uysal Omer,
Dansuk Ramazan
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.11.013
Subject(s) - medicine , myometrium , fibrous joint , surgery , cesarean delivery , uterus , pregnancy , biology , genetics
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.