Online survey on uterotomy closure techniques in caesarean section

Area of Science:

• Obstetrics and Gynecology
• Surgical Techniques
• Maternal Health

Background:

• Uterine closure methods in caesarean section (CS) can affect subsequent pregnancy outcomes.
• Lack of standardized recommendations for uterine closure techniques exists.
• Understanding current practices is crucial for evaluating late pregnancy complications.

Purpose of the Study:

• To survey current uterine closure techniques used in German hospitals during CS.
• To determine the frequency of late pregnancy complications associated with different CS closure methods.
• To assess the feasibility of national online surveys for obstetric topics.

Main Methods:

• An anonymous online questionnaire was distributed to 648 German hospitals.
• Data collected included CS rates, vaginal birth after CS (VBAC) rates, uterine suturing techniques, and complication frequencies (dehiscence, rupture, PAS).
• Results were evaluated using descriptive statistics.

Main Results:

• The response rate was 24.7%.
• Single-layer continuous sutures were the most common technique (74.4%).
• No significant difference in uterine dehiscence rates was found between different hospital levels or suturing techniques.

Conclusions:

• A uniform uterine closure technique for CS is not established in Germany.
• Detailed surgical reporting of uterine closure techniques is necessary for complication assessment.
• National online surveys are effective for gathering data and promoting discussion on standardized obstetric practices.