Ultrasound cesarean scar assessment one year postpartum in relation to one- or two-layer uterine suture closure

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F20%3A43918769" target="_blank" >RIV/00216208:11120/20:43918769 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00023698:_____/20:N0000004

Výsledek na webu

<a href="https://doi.org/10.1111/aogs.13714" target="_blank" >https://doi.org/10.1111/aogs.13714</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/aogs.13714" target="_blank" >10.1111/aogs.13714</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Ultrasound cesarean scar assessment one year postpartum in relation to one- or two-layer uterine suture closure

Popis výsledku v původním jazyce

INTRODUCTION: This study compared healing of the scars after cesarean section during the first postpartum year using a single or double layer suturing technique. Scar was assessed by a transvaginal ultrasound. We explored the appearance and localization of uterine scars with regards to the obstetric history. Our aim was to compare the position of the scar or defect, if present, its dimensions, and any residual myometrium with respect to the suturing technique during the cesarean section. MATERIAL AND METHODS: Women with uncomplicated singleton pregnancies indicated for elective or acute cesarean section were randomly allocated to the uterine closure technique group. During the first postpartum year, their lower uterine segment was examined with a transvaginal ultrasound in 3 consecutive visits at 6 weeks, 6 months, and 12 months. RESULTS: 324 women had the 12 months visit, out of these 149 underwent single layer closure of the uterine incision, 175 underwent double-layer technique. A higher proportion of the defects is seen in the single layer closure technique of suturing. Defects in the single layer group were wider (0.002) and the residual myometrial thickness in the single layer group were thinner (0.019). Women who underwent cesarean section at the stage of full cervical dilation had scars that were closer to the external cervical os (0.000). The position of the uterus varies greatly between controls (0.000). The combination of uterine position and scar defect presence changes significantly between controls (0.001), and it varies significantly depending on the suturing method (0.003). Defects with or without contact with the uterine cavity changes statistically between controls (0.017). Both types of defects are more common in a in the single layer closure technique group. CONCLUSIONS: The findings of this study demonstrate that double layer technique with the first continuous nonlocking suture followed by a second continuous nonlocking suture is associated with better suture healing and greater residual myometrial thickness. No difference was observed between single- and double-layer closure for the presence of maternal infectious morbidity, wound infection and blood transfusion.

Název v anglickém jazyce

Ultrasound cesarean scar assessment one year postpartum in relation to one- or two-layer uterine suture closure

Popis výsledku anglicky

INTRODUCTION: This study compared healing of the scars after cesarean section during the first postpartum year using a single or double layer suturing technique. Scar was assessed by a transvaginal ultrasound. We explored the appearance and localization of uterine scars with regards to the obstetric history. Our aim was to compare the position of the scar or defect, if present, its dimensions, and any residual myometrium with respect to the suturing technique during the cesarean section. MATERIAL AND METHODS: Women with uncomplicated singleton pregnancies indicated for elective or acute cesarean section were randomly allocated to the uterine closure technique group. During the first postpartum year, their lower uterine segment was examined with a transvaginal ultrasound in 3 consecutive visits at 6 weeks, 6 months, and 12 months. RESULTS: 324 women had the 12 months visit, out of these 149 underwent single layer closure of the uterine incision, 175 underwent double-layer technique. A higher proportion of the defects is seen in the single layer closure technique of suturing. Defects in the single layer group were wider (0.002) and the residual myometrial thickness in the single layer group were thinner (0.019). Women who underwent cesarean section at the stage of full cervical dilation had scars that were closer to the external cervical os (0.000). The position of the uterus varies greatly between controls (0.000). The combination of uterine position and scar defect presence changes significantly between controls (0.001), and it varies significantly depending on the suturing method (0.003). Defects with or without contact with the uterine cavity changes statistically between controls (0.017). Both types of defects are more common in a in the single layer closure technique group. CONCLUSIONS: The findings of this study demonstrate that double layer technique with the first continuous nonlocking suture followed by a second continuous nonlocking suture is associated with better suture healing and greater residual myometrial thickness. No difference was observed between single- and double-layer closure for the presence of maternal infectious morbidity, wound infection and blood transfusion.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30214 - Obstetrics and gynaecology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Acta Obstetricia et Gynecologica Scandinavica

ISSN

0001-6349

e-ISSN

—

Svazek periodika

99

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

DK - Dánské království

Počet stran výsledku

10

Strana od-do

69-78

Kód UT WoS článku

000487741300001

EID výsledku v databázi Scopus

2-s2.0-85073936847