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Z Geburtshilfe Neonatol 2021; 225(02): 140-145
DOI: 10.1055/a-1179-1393
Original Article

Hydrosonographic Assessment of the Effect of Two Different Suture Materials on Healing of the Uterine Scar after Cesarean Delivery: A Prospective Randomized Controlled Trial

Osman Sevket
1   Obstetrics and gynecology, Bezmialem Vakif University, Istanbul, Turkey
,
Taha Takmaz
1   Obstetrics and gynecology, Bezmialem Vakif University, Istanbul, Turkey
,
Pinar Ozcan 
1   Obstetrics and gynecology, Bezmialem Vakif University, Istanbul, Turkey
,
Belfin Nur Arici Halici
1   Obstetrics and gynecology, Bezmialem Vakif University, Istanbul, Turkey
,
Sevde Havva Islek
1   Obstetrics and gynecology, Bezmialem Vakif University, Istanbul, Turkey
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Abstract

Purpose This study aimed to compare the effects of two different suture materials, monofilament synthetic absorbable sutures versus multifilament synthetic absorbable sutures, on healing the uterine scar after a cesarean delivery.

Methods A total of 95 women between the ages of 18 and 40 who had undergone a primary cesarean section (CS) after the 38th week of gestation. In Group I (n=48), continuous double-layer unlocked closure of the low transverse uterine incision was performed using monofilament synthetic absorbable sutures. In Group II (n=47), continuous double-layer unlocked closure of the low transverse uterine incision was performed using multifilament synthetic absorbable sutures. Six months after the operation, the integrity of the cesarean scar at the uterine incision site was assessed using hydrosonography. The healing ratio and the thickness of the residual myometrium covering the defect were calculated as markers of uterine scar healing.

Results No statistically significant differences were observed between the groups with regard to the preoperative hemoglobin concentrations, the change in the hemoglobin concentrations, operating time, and the number of intraoperative additional hemostatic uterine sutures. Mean thickness of the residual myometrium covering the defect was thicker in the monofilament suture group in comparison to the multifilament suture group (7.76±2.11 vs. 5.96±1.69, respectively; p<0.01). The mean healing ratio was significantly higher in the monofilament suture group in comparison to the multifilament suture group (0.76±0.13 vs. 0.60±0.12, respectively; p<0.01)

Conclusion Continuous double-layer unlocked closure of the uterine incision at cesarean delivery using monofilament synthetic absorbable sutures decreases the risk of CS scar defect.

Key words

Cesarean delivery - Hydrosonography - Isthmocele - Scar defect - Suture material


Publikationsverlauf

Eingereicht: 12. März 2020

Angenommen: 05. Mai 2020

Artikel online veröffentlicht:
25. Juni 2020

© 2020. Thieme. All rights reserved.

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