Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study
ABSTRACT Purpose: This study investigated the hypothesis of early dehiscence of hysterorrhaphy as the initial stage of post-cesarean uterine scar defects, examining the possible influence of barbed suture in this process. Methods: This longitudinal, prospective, double-blind study included 54 preg...
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Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
2024-11-01
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| Series: | Acta Cirúrgica Brasileira |
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| author | Newton de Paula Ishikawa Gabriela Ewerling Souza Thays Andressa Albuquerque Monteiro Albert Schiaveto de Souza Ricardo Dutra Aydos Durval Batista Palhares |
| author_facet | Newton de Paula Ishikawa Gabriela Ewerling Souza Thays Andressa Albuquerque Monteiro Albert Schiaveto de Souza Ricardo Dutra Aydos Durval Batista Palhares |
| author_sort | Newton de Paula Ishikawa |
| collection | DOAJ |
| description | ABSTRACT Purpose: This study investigated the hypothesis of early dehiscence of hysterorrhaphy as the initial stage of post-cesarean uterine scar defects, examining the possible influence of barbed suture in this process. Methods: This longitudinal, prospective, double-blind study included 54 pregnant women with no history of cesarean section, randomized into two suture groups: #0 polyglactin or #1 barbed PDS threads. Sutures were continuous, unlocked, involved the entire myometrium in a single layer, and included the endometrium. Tridimensional transvaginal ultrasonography was performed on the second day postpartum to investigate scar dehiscence and measure its maximal width. Results: The groups had 29 and 25 participants, respectively. Ages: 18–37 (mean 25.80 ± standard error of the mean 0.69) years old. Groups were homogeneous for labor duration, cervical thickness, edge-to-os distance, retroversion, amniotic sac rupture, and additional hemostatic sutures required. Uterine retroversion accounted for 7.4% of cases. Dehiscence was observed in 68.5% (3.98 ± 0.57 mm). The only factor correlating (positively) with dehiscence width was myometrial thickness, whether proximal or distal. Conclusions: Suture type had no influence on early dehiscence, which occurred at the same rate as published niche formation rates. Tridimensional ultrasound proved effective for evaluating dehiscence. |
| format | Article |
| id | doaj-art-cfbdf2529e4946b887ce20efb2a24d58 |
| institution | Kabale University |
| issn | 1678-2674 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
| record_format | Article |
| series | Acta Cirúrgica Brasileira |
| spelling | doaj-art-cfbdf2529e4946b887ce20efb2a24d582024-12-17T07:49:41ZengSociedade Brasileira para o Desenvolvimento da Pesquisa em CirurgiaActa Cirúrgica Brasileira1678-26742024-11-013910.1590/acb399124Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical studyNewton de Paula Ishikawahttps://orcid.org/0000-0002-8968-3797Gabriela Ewerling Souzahttps://orcid.org/0009-0003-5595-0337Thays Andressa Albuquerque Monteirohttps://orcid.org/0009-0008-8029-3742Albert Schiaveto de Souzahttps://orcid.org/0000-0003-0017-672XRicardo Dutra Aydoshttps://orcid.org/0000-0003-2371-536XDurval Batista Palhareshttps://orcid.org/0000-0002-4300-6125ABSTRACT Purpose: This study investigated the hypothesis of early dehiscence of hysterorrhaphy as the initial stage of post-cesarean uterine scar defects, examining the possible influence of barbed suture in this process. Methods: This longitudinal, prospective, double-blind study included 54 pregnant women with no history of cesarean section, randomized into two suture groups: #0 polyglactin or #1 barbed PDS threads. Sutures were continuous, unlocked, involved the entire myometrium in a single layer, and included the endometrium. Tridimensional transvaginal ultrasonography was performed on the second day postpartum to investigate scar dehiscence and measure its maximal width. Results: The groups had 29 and 25 participants, respectively. Ages: 18–37 (mean 25.80 ± standard error of the mean 0.69) years old. Groups were homogeneous for labor duration, cervical thickness, edge-to-os distance, retroversion, amniotic sac rupture, and additional hemostatic sutures required. Uterine retroversion accounted for 7.4% of cases. Dehiscence was observed in 68.5% (3.98 ± 0.57 mm). The only factor correlating (positively) with dehiscence width was myometrial thickness, whether proximal or distal. Conclusions: Suture type had no influence on early dehiscence, which occurred at the same rate as published niche formation rates. Tridimensional ultrasound proved effective for evaluating dehiscence.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502024000100813&lng=en&tlng=enCesarean SectionDiagnostic Techniques, Obstetrical and GynecologicalSuture Techniques |
| spellingShingle | Newton de Paula Ishikawa Gabriela Ewerling Souza Thays Andressa Albuquerque Monteiro Albert Schiaveto de Souza Ricardo Dutra Aydos Durval Batista Palhares Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study Acta Cirúrgica Brasileira Cesarean Section Diagnostic Techniques, Obstetrical and Gynecological Suture Techniques |
| title | Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study |
| title_full | Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study |
| title_fullStr | Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study |
| title_full_unstemmed | Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study |
| title_short | Cesarean scar dehiscence in early puerperium and influence of barbed suture: tridimensional ultrasound evaluation in a randomized clinical study |
| title_sort | cesarean scar dehiscence in early puerperium and influence of barbed suture tridimensional ultrasound evaluation in a randomized clinical study |
| topic | Cesarean Section Diagnostic Techniques, Obstetrical and Gynecological Suture Techniques |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502024000100813&lng=en&tlng=en |
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