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Single- or double-layer uterine closure techniques following cesarean: A randomized trial.

剖宫产术后单层或双层子宫闭合技术: 一项随机试验。

  • 影响因子:2.21
  • DOI:10.1111/aogs.14018
  • 作者列表:"Yılmaz Baran Ş","Kalaycı H","Doğan Durdağ G","Yetkinel S","Alemdaroğlu S","Çok T","Bulgan Kılıçdağ E
  • 发表时间:2021-03-01
Abstract

INTRODUCTION:Cesarean deliveries are commonly performed throughout the world. Although the uterine closure technique following this procedure may influence how the uterine scar heals, there is insufficient evidence for choosing the appropriate technique and so preventing long-term negative consequences. This prospective, randomized study examined the effects of single- and double-layer uterine closure techniques on uterine scar healing following cesarean delivery. MATERIAL AND METHODS:This study assessed a total of 282 women aged 18-45 years who were in gestational weeks 24-41 of singleton pregnancies. None had previously undergone uterine surgeries. These participants completed their first cesarean deliveries at the time of study and were randomized into the following two treatment groups: single-layer closure with locking and double-layer closure with locking in the first layer, but not in the second layer (NCT03629028). However, the decidua was not included for treatment in either group. Participants were evaluated at 6-9 months after cesarean section by saline infusion sonohysterography to assess cesarean delivery scar defects. These procedures were conducted by experienced sonographers who were not aware of the uterine closure technique. RESULTS:Of the 225 final participants, 109 received the single-layer closure technique, whereas 116 received the double-layer technique. The niche rates were 37% (n = 40) for the single-layer group and 45.7% (n = 53) for the double-layer group (P = .22, relative risk 1.4, 95% CI = 0.8-4.4). CONCLUSIONS:The single- and double-layer closure techniques did not produce different impacts on uterine scar niche development.

摘要

引言: 世界各地通常进行剖宫产。虽然该手术后的子宫闭合技术可能会影响子宫疤痕如何愈合,但没有足够的证据来选择合适的技术,从而防止长期的负面后果。这项前瞻性、随机研究考察了单层和双层子宫闭合技术对剖宫产术后子宫瘢痕愈合的影响。 材料和方法: 本研究共评估了282名18-45岁的女性,她们在24-41孕周的单胎妊娠中。以前没有人接受过子宫手术。这些参与者在研究时完成了他们的首次剖宫产,并被随机分为以下两个治疗组: 单层闭合带锁定和双层闭合带锁定在第一层,但不在第二层 (NCT03629028).然而,两组均未将蜕膜纳入治疗。在剖宫产后6-9个月,通过盐水灌注超声宫腔造影评估剖宫产瘢痕缺陷。这些手术由经验丰富的超声医师进行,他们不知道子宫闭合技术。 结果: 在225名最终参与者中,109接受了单层闭合技术,而116接受了双层技术。单层组的生态位率为37% (n = 40),双层组为45.7% (n = 53) (P = .22,相对风险1.4,95% CI = 0.8-4.4)。 结论: 单层和双层封闭技术对子宫瘢痕小生境的发育没有产生不同的影响。

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