Longitudinal transvaginal ultrasound evaluation of cesarean scar niche incidence and depth in the first two years after single- or double-layer uterotomy closure: a randomized controlled trial.
Acta Obstet Gynecol Scand
; 96(12): 1484-1489, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28832909
ABSTRACT
INTRODUCTION:
Cesarean deliveries are the most common abdominal surgery procedure globally, and the optimal way to suture the hysterotomy remains a matter of debate. The aim of this study was to assess the incidence of cesarean scar niches and the depth after single- or double-layer uterine closure. MATERIAL ANDMETHODS:
We performed a randomized controlled trial in which women were allocated to three uterotomy suture techniques continuous single-layer unlocked, continuous locked single-layer, or double-layer sutures. Transvaginal ultrasound was performed six weeks and 6-24 months after cesarean delivery [Clinicaltrials.gov (NCT02338388)].RESULTS:
The study included 435 women. Six weeks after delivery, the incidence of niche was not significantly different between the groups (p = 0.52) 40% for single-layer unlocked, 32% for single-layer locked and 43% for double-layer sutures. The mean ± SD niche depths were 3.0 ± 1.4 mm for single-layer unlocked, 3.6 ± 1.7 mm for single-layer locked and 3.3 ± 1.3 mm for double-layer sutures (p = 1.0). There were no significant differences (p = 0.58) in niche incidence between the three groups at the second ultrasound follow up 30% for single-layer unlocked, 23% for single-layer locked and 29% for double-layer sutures. The mean ± SD niche depth was 3.1 ± 1.5 mm after single-layer unlocked, 2.8 ± 1.5 mm after single-layer locked and 2.5 ± 1.2 mm after double-layer sutures (p = 0.61). There was a trend (p = 0.06) for the residual myometrium thickness to be thicker after double-layer repair at the long-term follow up.CONCLUSIONS:
The incidence of cesarean scar niche formation and the niche depth was independent of the hysterotomy closure technique.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cesárea
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Técnicas de Sutura
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Ultrassonografia
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Cicatriz
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Miométrio
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Incidence_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Acta Obstet Gynecol Scand
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Alemanha