Risk of Uterine Rupture Following Locked Vs Unlocked Single-layer Closure - Zdravlje, medicina, lijecenje, zdravstveni portal

Risk of Uterine Rupture Following Locked Vs Unlocked Single-layer Closure

Risk of Uterine Rupture Following Locked Vs Unlocked Single-layer Closure
Igor Hudic, Emmanuel Bujold, Zlatan Fatusic, Stéphanie Roberge, Amer Mandzic, Jasenko Fatusic
Med Arh. 2012; 66(6): 412-414

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Abstract

Objective: To compare the rate of uterine scar disruption after a locked versus an unlocked single-layer closure of the hysterotomy incision at a previous cesarean. Methods: A retrospective cohort study in a population where both locked and unlocked single-layer closure are commonly used. All singleton pregnancies at 24 weeks’ gestation or more with a previous single cesarean were included. Rate of uterine scar disruption (complete uterine rupture and uterine scar dehiscence) were compared between women with a previous locked and those with a previous unlocked single-layer closure of the uterus. Results: Out of 388 women included in the study, 272 had a previous unlocked single-layer closure and 116 had a locked single-layer closure. We found no significant difference in the rate of uterine scar disruption between the two groups (5.9% vs 8.6%, p=0.32). Conclusion: Locking a single-layer closure was not associated with an increase rate of uterine scar disruption at the next pregnancy in our retrospective analysis. A randomized trial should be performed.

REFERENCES

1. Hudiæ I, Fatušiæ Z, Kameriæ L, Mišiæ M, Šerak I, Latifagiæ A. Vaginal delivery after Misgav-Ladach cesarean section—is the risk of uterine rupture acceptable? J Matern Fetal Neonatal Med. 2010;23(10): 1156-1159.

2. Guise JM, McDonagh MS, Osterweil P, Nygren P, Chan BK, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous cesarean section. BMJ. 2004; 329(7456): 19–25.

3. Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ. The impact of a single-layer or double-layer closure on uterine rupture. Am J Obstet Gynecol. 2002; 186(6): 1326-1330.

4. GyamfiC, JuhaszG, GyamfiP, BlumenfeldY, StoneJL. Single-versus double-layer uterine incision closure and uterine rupture. J Matern Fetal Neonatal Med. 2006; 19: 639-43.

5. Bujold E, Goyet M, Marcoux S, Brassard N, Cormier B, Hamilton E et al. The role of uterine closure in the risk of uterine rupture. Obstet Gynecol. 2010; 116(1): 43-50.

6. Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ. The impact of a single-layer or double-layer closure on uterine rupture. Am J Obstet Gynecol. 2002; 186: 1326-1330.

7. Durnwald C, Mercer B. Uterine rupture, perioperative and perinatal morbidity after single-layer and double-layer closure at cesarean delivery. Am J Obstet Gynecol. 2003; 189: 925-929.

8. Xavier P, Ayres-De-Campos D, Reynols A, Guimaraes M, Costa-Sabtos C, Patricio B. The modified Misgav-Ladach versus the Pfannenstiel technique for cesarean section: a randomized trial. Acta Obstet Gynecol Scand. 2005; 84: 878-882.

9. Jastrow N, Gauthier RJ, Gagnon G, Leroux N, Beaudoin F, Bujold E. Impact of labor at prior cesarean on lower uterine segment thickness in subsequent pregnancy. Am J Obstet Gynecol. 2010; 202(563): 1-7.

10. Roberge S, Chaillet N, Boutin A, Moore L, Jastrow N, Brassard N et al. Single- versus double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture. Int J Gynaecol Obstet. 2011; 115: 5-10.

11. Jelsema RD, Wittingen JA, Vander Kolk KJ. Continuous, nonlocking, single-layer repair of the low transverse uterine incision. J Reprod Med. 38: 393-396.

12. Ferrari AG, Frigerio LG, Candotti G, Buscaglia M, Petrone M, Taglioretti A, Calori G. Can Joel-Cohen incision and single layer reconstruction reduce cesarean section morbidity? Int J Gynaecol Obstet. 2001; 72: 135-43.

13. Hofmeyr GJ, Mathai M, Shah A, Novikova N. Techniques for caesarean section. Cochrane Database Syst Rev, 2008; 23(1): CD004662.

14. Menacker F, Hamilton BE. Recent trends in cesarean delivery in the United States. 375 NCHS Data Brief. 2010; 35: 1–8.

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