• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Single or Double-Layer Closure at C-Section and Resulting Uterine Thickness

image_pdfFavoriteLoadingFavorite

PURPOSE:

This study by Vachon-Marceau et al. (AJOG, 2017) aimed to determine if there is a difference in lower uterine segment thickness depending on single or double-layer C-section uterine closure.

METHODS:

Prospective Cohort Study

RESULTS:

There is an increased risk of uterine rupture during a trial of labor following C-section. Uterine thickness on ultrasound has been studied as a proxy for scar quality and risk of rupture in future pregnancies. In this study, 1,613 women underwent transabdominal and transvaginal ultrasounds in their third trimester to assess lower uterine segment thickness and scar defects resulting from previous C-section. The sonographers were blinded to clinical information.  495 (31%) women had previously underwent a single-layer and 1,118 (69%) had a double-layer closure. Women who had a double-layer closure had thicker lower uterine segments than women with single-layer closure with a difference of 0.11 mm (95% CI, 0.02-0.21 mm). Using multivariate logistic regression to account for variables, double-layer closure was less likely to result in a thin lower uterine segment thickness of < 2.0 mm (odds ratio 0.68; 95% CI, 0.51-0.90). Double-layer closure was also associated with a decreased risk of uterine scar defect with a relative risk of 0.32 (95% CI, 0.17 – 0.61) at birth. Type of thread (catgut vs. synthetic) used for closure had no impact on lower uterine thickness.  The authors conclude that double-layer closure resulted in reduced risk of uterine segment thickness <0.2 mm and visible uterine scar defect on ultrasound in the third trimester.

Learn More – Primary Sources:

Single versus double-layer uterine closure at cesarean: impact on lower uterine segment thickness at next pregnancy

image_pdfFavoriteLoadingFavorite

< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

C-Section Skin Closure: Glue or Subcuticular Sutures?
What is the best skin prep to prevent C-section wound infections?
Do Different Surgical C-Section Techniques Affect Outcomes?
What are Risk Factors Associated with Complete Uterine Rupture?
Practical info on evidence based medicine for your women's healthcare practice
Is it better to leave the uterus in the abdominal cavity or exteriorize it following C-section?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site