IMR Press / CEOG / Volume 48 / Issue 6 / DOI: 10.31083/j.ceog4806228
Open Access Original Research
Comparison of different uterine incision closure methods used in cesarean section in terms of postoperative cesarean incision scar thickness and isthmocele formation: a prospective, randomized study
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1 Department of Obstetrics and Gynecology, Arhavi State Hospital, 08200 Artvin, Turkey
2 Department of Gynecologic Oncology, Antalya Training and Research Hospital, 07100 Antalya, Turkey
3 Department of Obstetrics and Gynecology, Faculty of Medicine, Dokuz Eylul University, 35340 Izmir, Turkey
*Correspondence: selim.kandemir@yandex.com (Selim Kandemir)
Clin. Exp. Obstet. Gynecol. 2021, 48(6), 1448–1453; https://doi.org/10.31083/j.ceog4806228
Submitted: 17 August 2021 | Revised: 9 October 2021 | Accepted: 8 November 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Objective: In parallel with the increase in cesarean section (CS) rates, the incidence of isthmocele has been increasing. In this study, we aimed to evaluate the effect of four different uterine incision closure techniques (single-layer locked, double-layer locked, single-layer unlocked, and double-layer unlocked) on cesarean scar healing and isthmocele formation by transvaginal ultrasound (TVUS) and saline infusion sonography (SIS). Materials and methods: This prospective, randomized study included women who underwent the first, elective, and term cesarean section delivery at the Obstetrics and Gynecology clinic of a tertiary care center between November 2018 and November 2019. A total of 60 patients were divided into four groups including 15 patients in each. Using the TVUS and SIS, the width, depth and length of the CS defect and the thickness of the residual myometrial tissue were measured. Results: There was no significant difference in the CS defect measurements and CS defect area among the four groups (p > 0.05). The lowest rate of Grade 3 isthmocele was seen in the double-locked group (5%), while the highest rate of isthmocele was seen in the single-unlocked group (35%) (p > 0.05). Conclusion: No trend of differences was seen in the four subgroups but the sample size is not big enough to draw valid conclusions.

Keywords
Cesarean delivery
Isthmocele
Saline infusion sonography
Uterus closure technique
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