Comparison Between the Effectiveness of single-layer and double-layer closure of the uterine incision during cesarian section in improving the rate of the thickness of the Lower uterine Segment after Surgery

Abstract

Background: The degree of the lower uterine segment (LUS) thinning and the risk of uterine scar defect have been studied.
However, the relationship between the methods of closure and the degree of thinning needs further elucidation.

Aim: The aim of this study was to determine whether a LUS transverse cesarean section (CS) closure method in one or two layers affects
subsequent scar thickness.

Subjects and Methods: In this prospective study, 60 women were enrolled and randomly assigned
to one- or two-layer closure of the LUS incision. Patients were divided into two groups. Each group included 30 patients, of
primigravidae with gestational age from 38 weeks to 40 weeks one group had a single layer closure and the other had a double
layer closure.

Follow-up: Patients had a vaginal ultrasonographic evaluation of the LUS immediately preoperative (baseline) and then follow-up
measurements at 48 h, and 2 weeks postoperatively.

Results: We found an increase in the thickness of LUS-CS scar in cases with double layer closure of the incision
than a single layer closure as depicted by ultrasonography after 2 days and 2 weeks post-operative.

Conclusion: These findings suggest that the number of closing layers of CS directly affect the thickness of the scar.