Assessment of Cesarean Section Uterine Scar by Transvaginal Ultrasound after Single Versus Double Layer Closure Techniques

Mousa, Hanan Abdelwahab Meselhy; Abdelhamed, Azza Abdelmageed; Sadek, Somayya Magdeldin; Gad, Abdallah Hassan

doi:10.21608/ejhm.2022.270487

Assessment of Cesarean Section Uterine Scar by Transvaginal Ultrasound after Single Versus Double Layer Closure Techniques

Document Type : Original Article

Authors

10.21608/ejhm.2022.270487

Abstract

Background: The best way to show a caesarean section (CS) scar is using transvaginal ultrasound, which has better detection rates. The objective of the current study is to detect sonographic features of CS scar after single layer and double layer closure techniques and determine those of better healing and niche development.
Patients and methods: A clinical trial was conducted on 74 pregnant at 39 weeks with single-tone pregnancies. Participants were divided into 2 equal groups. Group SL included 39 primigravidae who underwent single layer closure of the uterine incision during CS, and Group DL included 37 primigravidae who underwent double layer closure of the uterine incision during CS. Participant women were subjected to thorough medical and obstetrical examination, and ultrasound check 3 months following their operations.
Results: Niche features revealed that patients in the double layer group had a significantly larger niche depth than those in the single layer group. Additionally, they had significantly greater residual myometrial thickness as compared to the single-layer group. No statistically significant difference in niche length, breadth, or neighboring myometrial thickness existed between the two groups. The residual myometrium thickness (RMT)/ adjacent myometrium thickness (AMT) ratio was utilized as a marker of uterine scar healing, and our findings indicated that patients in the double layer group had considerably higher healing "RMT/AMT" ratios than those in the single layer group.
Conclusion: With closure of CS incision by double layer, better outcomes have occurred, including incidence of niche development, residual myometrial thickness and healing ratio than the single layer closure.

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