Myorrhaphy surgical techniques

Abstract

Although vaginal birth is currently encouraged after a previous cesarean section, the rate of cesarean section has steadily increased in the last 10 years from 5% to 30-32%. As the rates of cesarean section increase, the rates of pathologies associated with uterine scarring increase, as for example pregnancy implanted at the level of the scar or various forms of invasive placenta. Using the search engines of the online libraries such as PubMed, Medscape, UpToDate, Cochrane, we selected studies on the surgical technique used in the caesarean section. For this paper, 8 scientific articles were selected considering both original articles and meta-analyzes, cumulating a total of 9675 patients distributed into two categories, namely single and double layer. Double-layer suture of the uterine incision is preferred over single-layer suture, but both meet medical standards. At present, the benefits of one technique compared to the other (single layer/ double layer) are not unanimously demonstrated; multiple variables must be considered such as the actual technique in making the layers, type of suture used (continuous interlocking or non-interlocking or separate sutures) and the obstetrician’s experience.