FACTORS INFLUENCING THE CHOICE OF UTERINE SUTURING METHOD DURING CESAREAN SECTION: ANALYSIS OF ANAMNESTIC DATA
Keywords:
cesarean section; uterine suturing; obstetric history; gynecological pathology; extragenital morbidity.Abstract
The choice of the uterine suturing method after a cesarean section plays an important role in reducing the risk of complications and affects subsequent reproductive outcomes. A study was conducted on 496 women aged 18 to 42 years who underwent cesarean section. Patients were divided into two groups depending on the method of uterine suturing: Group 1 – 240 (48%) women with modified uterine suturing, and Group 2 – 256 (52%) women with traditional suturing. The analysis of anamnestic data included the assessment of indications for the first cesarean section, extragenital and gynecological morbidity, as well as previously performed surgical interventions. The obtained results showed that the choice of the uterine suturing method is largely determined by the somatic and obstetric-gynecological history of the patient, requiring an individualized approach to surgical tactics.
References
Betrán A.P., Ye J., Moller A.-B. et al. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990–2014. PLOS ONE. 2016; 11(2): e0148343.
Boerma T., Ronsmans C., Melesse D.Y. et al. Global epidemiology of use of and disparities in caesarean sections. The Lancet. 2018; 392(10155): 1341–1348.
Di Spiezio Sardo A., Saccone G., McCurdy R. et al. Risk of Cesarean scar defect following single- vs double-layer uterine closure: systematic review and meta-analysis of randomized controlled trials. American Journal of Obstetrics and Gynecology. 2017; 217(5): 463–472.
Vikhareva Osser O., Valentin L. Risk factors for incomplete healing of the uterine incision after caesarean section. BJOG. 2010; 117(9): 1119–1126.
Bujold E., Goyet M., Marcoux S., Brassard N., Cormier B. The role of uterine closure in the risk of uterine rupture. Obstetrics and Gynecology. 2010; 116(1): 43–50.
Vachon-Marceau C., Demers S., Bujold E. et al. Single versus double-layer uterine closure at cesarean: impact on lower uterine segment thickness at next pregnancy. American Journal of Obstetrics and Gynecology. 2017; 217(1): 65.e1–65.e5.
Stegwee S.I., Malotaux A.M., Huirne J.A., Van den Berg L.A., Lambalk C.B., Hink E. Uterine caesarean closure techniques affect ultrasound findings and maternal outcomes: a systematic review and meta-analysis. Ultrasound in Obstetrics and Gynecology. 2018; 51(2): 165–175.
Babu R., Magon N. Single versus double-layer uterine closure at cesarean: impact on uterine scar thickness and reproductive outcomes. Journal of Obstetrics and Gynaecology of India. 2021; 71(1): 34–40.
Stegwee S.I., van den Tweel M.M., Malotaux A.M. et al. The impact of single- vs double-layer closure on adverse outcomes and uterine scar defect: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 2019; 221(5): 437–448.
Pomorski M., Fuchs T., Zimmer M. The risk factors of uterine scar dehiscence and rupture – literature review. Ginekologia Polska. 2019; 90(4): 195–202.
Roberge S., Demers S., Bujold E. Impact of uterine closure on residual myometrial thickness after cesarean: a randomized controlled trial. American Journal of Obstetrics and Gynecology. 2016; 215(4): 507.e1–507.e6.
Hayakawa H., Itakura A., Mitsui T. et al. Methods for assessing the thickness of the lower uterine segment in pregnant women with previous cesarean delivery. Acta Obstetricia et Gynecologica Scandinavica. 2006; 85(4): 490–494.
Hayakawa H., Kinoshita K., Kanayama N. et al. Sonographic evaluation of the lower uterine segment during pregnancy: a comparison of transvaginal and transabdominal ultrasonography. Journal of Obstetrics and Gynaecology Research. 2011; 37(2): 93–99.
Rozenberg P., Goffinet F., Phillippe H.J. et al. Ultrasonographic measurement of lower uterine segment thickness and risk of uterine rupture. Obstetrics and Gynecology. 1996; 87(4): 597–601.
Jastrow N., Roberge S., Gauthier R.J. et al. Impact of single- vs double-layer closure on adverse outcomes and uterine scar defect: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 2019; 221(5): 437.e1–437.e13.
Roberge S., Chaillet N., Boutin A. et al. Single- vs double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture. American Journal of Obstetrics and Gynecology. 2014; 211(5): 500.e1–500.e10.
Betrán A.P., Torloni M.R., Zhang J.J., Gülmezoglu A.M. WHO statement on caesarean section rates. BJOG. 2016; 123(5): 667–670.