Open AccessComparison of the primary cesarean hysterotomy scars after single‐ and double‐layer interrupted closure
Author(s) -
Kataoka Soromon,
Tanuma Fumie,
Iwaki Yutaka,
Iwaki Kurumi,
Fujii Takeru,
Fujimoto Toshio
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13015
Subject(s) - hysterotomy , medicine , niche , myometrium , ecological niche , odds ratio , prospective cohort study , pregnancy , surgery , gestation , biology , uterus , ecology , genetics , habitat
It is unclear whether hysterotomy closure techniques can affect niche development. Therefore, this study aimed to analyze the effect of single‐layer and double‐layer interrupted closures of hysterotomy incisions during primary cesarean section on the formation of uterine niches. Material and methods A prospective cohort study of women undergoing primary cesarean section was performed between June 2011 and July 2014. Saline contrast sonohysterography was used to measure the niche depth and residual myometrium. The ratio of the niche depth to the sum of the niche depth and residual myometrium thickness (niche ratio) was calculated. Results Niches were identified in 14/58 (24.1%) women with single‐layer sutures and 55/209 (26.3%) women with double‐layer sutures ( p = 0.74). Single‐layer closure was associated with more than a five‐fold increase in the odds of a niche ratio ≥0.4 (odds ratio 5.59; 95% CI 1.71–18.28). Conclusion Single‐layer closure may be associated with an increased risk of larger niches (niche ratio ≥0.4), although it may not increase the overall frequency of niche formation.