Ultrasonographic Evaluation of Cesarean Scar Defect after Double-layered Uterine Suture versus Single-layer Continuous Uterine Suture

Document Type : Original Article

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Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt

Abstract

Background: Currently, researchers are comparing uterine incision closure techniques and looking for ways to reduce associated risks.
The aim of the work: To compare postoperative outcomes of single layer versus double layer unlocked sutures for closure of the uterine incision during cesarean section.
Patients and Methods: This randomized controlled trial was conducted at Al-Azhar University in Damietta, Egypt on 110 patients divided into two groups. In Group I [n=55], the uterine incision was closed with a single layer unlocked suture using No. 1 vicryl. In Group II [n=55], the uterine incision was closed with a double layer unlocked suture using No. 1 vicryl. All cases underwent full medical history taking, complete clinical examination, and preoperative investigations.
Results: While the uterine scar level was significantly lower in the single layer unlocked group [p= 0.012], the obtained scars after double layer unlocked suture were significantly thicker [RMT = 4.53 ± 2.09 vs. 6.96 ± 2.55]. A significant statistical difference was found between the two groups regarding residual myometrial thickness and defect depth and width three months postoperatively favoring Group II. A significant statistical difference was also found between the two groups regarding residual myometrial thickness and defect depth and width six months postoperatively favoring Group II.
Conclusion: The double layer unlocked uterine closure technique is associated with better cesarean scar healing in terms of RMT and CS defect incidence compared to the single layer unlocked technique. 

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