This study compares the effect of two techniques of uterine closure, with or without endometrial suturing on isthmocele development after cesarean section.
Cesarean section is the most common surgery performed on pregnant women. Poor healing of the incision of the uterus leads to isthmocele development. Long-term morbidities associated with isthmocele are uterine scar pregnancy, uterine perforation, pelvic pain, and spotting-style bleeding after menstruation. Many factors that may affect the healing of uterine scar have been studied in the literature (i.e. Double or single-layer closure, locked or unlocked closure, uterine retroflection). Suturing complete fold of the wound lips during the closure of the uterus may cause the endometrial layer to be embedded in the myometrium and to form niche tissue. The study hypothesized that isthmocele development can be reduced by suturing without enclosing the endometrium during uterine closure.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
170
Closure of the uterus at the time of primary cesarean will be performed with suturing the endometrium.
Closure of the uterus at the time of primary cesarean will be performed without suturing the endometrium.
Kocaeli University
Kocaeli, Turkey (Türkiye)
Number of patients with isthmocele six month after cesarean section
Residual myometrium thickness of less then 2.5 mm with transvaginal ultrasonography
Time frame: 6 months after intervention
Mean myometrium thickness
Myometrial thickness measured at incision site with transvaginal ultrasonography
Time frame: 6 months after intervention
Spotting
The rate of spotting complains of patients
Time frame: 6 months after intervention
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