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We compares two techniques of uterine closure on myometrium thickness at the site of uterine scar of women who underwent repeated cesarean section. We will evaluate myometrial thickness by transvaginal ultrasound six months after cesarean.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single layer | Placebo Comparator | Single layer closure |
|
| Double layer with resection | Active Comparator | Double layer closure after resection uterine scar |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Single layer closure | Procedure | Uterine incision will be approximated with continuous unlocked suture avoiding the inclusion endometrium and without trimming incision edges. |
|
| Measure | Description | Time Frame |
|---|---|---|
| residual myometrial thickness | Myometrial thickness at the uterine scar by transvaginal ultrasound | 6 months after cesarean |
| Measure | Description | Time Frame |
|---|---|---|
| residual myometrial thickness | Myometrial thickness at the uterine scar by transvaginal ultrasound | 6 weeks after cesarean |
| Healing ratio | residual myometrial thickness * 100 /total myometrial thickness above uterine scar |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Raşit Özler, Md | Contact | 00905465252595 | m.rasitozler@gmail.com | |
| ragıp a al, md | Contact | 00904423447649 | atakanal@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atatürk Üniversitesi araştırma Hastanesi | Recruiting | Erzurum | 25240 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40836292 | Derived | Ozler MR, Al RA. A prospective comparative study of single-layer versus double-layer uterine closure techniques on cesarean scar formation. BMC Pregnancy Childbirth. 2025 Aug 20;25(1):868. doi: 10.1186/s12884-025-08010-3. |
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| Double layer closure after resection uterine scar | Procedure | Uterine incision will be trimmed and old scar tissue will be removed. Then first, endometrium will be approximated by continuous unlocked suture mimicking subcuticular suture avoiding the inclusion of endometrium and second, upper part of myometrium will be approximated by a continuous unlocked suture. |
|
| 6 months after cesarean |
| Healing ratio | residual myometrial thickness * 100 /total myometrial thickness above uterine scar | 6 weeks after cesarean |
| Existence of cesarean scar defect | The presence or absence of a cesarean scar defect that was defined as any unechogenic area visualised by transvaginal ultrasound at the site of the cesarean scar with a depth of at least 1 mm. | 6 months after cesarean |
| Existence of cesarean scar defect | The presence or absence of a cesarean scar defect that was defined as any unechogenic area visualised by transvaginal ultrasound at the site of the cesarean scar with a depth of at least 1 mm. | 6 weeks after cesarean |
| Operation time | skin-to-skin operation time | 10 minute after cesarean completed |
| Change in hemoglobin | Difference in haemoglobin measured preoperatively and postoperatively 48 hours | 48 hours after cesarean |
| Blood product transfusion | unite number of transfused packed erythrocyte | One week after cesarean |
| Maternal infectious morbidity | prevalence of postpartum endometritis, skin wound dehiscence and post operative fever. | six weeks after cesarean |
| Length of hospitalization | Duration in days | One month after cesarean |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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