The purpose of this study was to compare the short term operative outcomes of three different surgical techniques for uterine incision closure during cesarean section (CS). This trial enrolled 120 patients scheduled for primary cesarean delivery. Patients were randomized into either classical double layer uterine closure, purse string double layer uterine closure (Turan), or our new approach of uterine closure (double layer step up-step down technique). For short term comparison, transvaginal ultrasonography was planned for all patients 6 weeks after surgery. Compared to group II and Group III, residual myometrial thickness was significantly thinner in group I (P\< 0.001). The number of patients with uterine niche was 10 (50% of all scar defects) in group I whereas it was 4 (20%) in group II and 6 (30%) in group III. Operative time was significantly longer in group II (P\< 0.001). This led to our conclusion that Turan technique and our new approach are associated with thicker myometrial thickness and less frequency of uterine scar defect than classical double layer uterine incision closure; however, our approach takes less operative time.
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residual myometrial thickness
Timeframe: 6 weeks after surgery