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Double-layered purse string uterine suture compared with single-layer continuous uterine suture: A randomized
Kaouther Dimassi1, Olivier Ami2, Rania Merai1
1Obstetrics and Gynecology Department, Mongi Slim University Hospital, La Marsa, Tunisia; University Tunis El Manar, Faculty of Medicine Tunis.
Journal of Gynecology Obstetrics and Human Reproduction
|December 21, 2021
Summary
A new double-layered purse string uterine suture (PSUS) technique significantly reduces cesarean scar defect (CSD) rates compared to single-layer continuous uterine suture (SLCUS). This improved CSD prevention occurred without increasing maternal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Surgical Innovation
- Reproductive Health
Background:
- Cesarean scar defects (CSDs) are a concern following cesarean deliveries.
- A novel purse string uterine suture (PSUS) technique was developed to prevent CSDs.
- The efficacy and safety of PSUS have not been formally evaluated.
Purpose of the Study:
- To test the hypothesis that double-layered PSUS reduces CSD rates compared to single-layer continuous uterine suture (SLCUS).
- To evaluate if PSUS increases perioperative maternal morbidity.
Main Methods:
- Prospective randomized study involving 100 patients.
- Patients were assigned to either PSUS or SLCUS groups.
- Hysterosonography was performed 6 months post-surgery to assess CSDs; operative time and blood loss were also recorded.
Main Results:
- The PSUS group showed a significantly lower CSD rate (6.66%) compared to the SLCUS group (40%).
- Operative time was longer for PSUS, but calculated blood loss was not significantly different.
- SLCUS was identified as a significant risk factor for CSDs.
Conclusions:
- Double-layered PSUS is superior to SLCUS in reducing cesarean scar defect rates.
- The PSUS technique does not increase perioperative maternal morbidity.
- PSUS represents a promising advancement in preventing CSDs.
