ASSESSMENT OF UTERINE SCAR AFTER MODIFIED DOUBLE LAYER VERSUS DOUBLE LAYER CLOSURE OF THE UTERUS DURING CESAREAN SECTION

Abstract

Background: Modified two layers closure consists of full thickness closure of uterus by interrupted horizontal mattress sutures in first layer followed by a continuous running suture in the second layer. To assess the healing of scar and the risk of uterine rupture in a subsequent pregnancy, ultrasonography is used in the evaluation of uterine scar in the postpartum period. Objective: To compare the effect of different suturing techniques in cesarean section in terms of blood loss and operative time during the operation and scar thickness three months after the operation. Patients and methods: The study included a total 60 women, they were divided into two equal groups: ● Group A underwent double layers closure of the uterus after lower segment cesarean section. ● Group B underwent modified double layers closure of the uterus after lower segment cesarean section. Ultrasound evaluation of the scar thickness was performed at three months post partum. Results: Results of the study showed that there was a statistically significant higher scar thickness in group B compared to group A. Conclusion: Change in suturing technique affected the thickness of uterine scar as detected by ultrasonography in post partum period. Scar thickness significantly increased with modified two layers closure when compared with traditional two layers closure of lower transverse uterine incision.