Single layer closure of the uterine wound at caesarean section. A safe technique?

C. Anastasiu, A. M. Dull, M. Moga

Abstract: Due to the large number of caesarean sections (CSs) performed, it has become necessary for professional obstetricians to gain more attention at every technical detail of the procedure in order to reduce the short and long term complications. In spite of the tremendous number of CSs, controversies still exists regarding to the modalities of uterine closure: mono versus double layer. The aim of the present study is to evaluate the risks of dehiscence or uterine rupture and adhesions formation generated by the caesarean sections technique. In this regard, we conducted a descriptive study on 204 pregnant women with a single previous low transverse caesarean section, performed by the same surgeon. We used in all cases the same technique, a single layer closure of the uterine wound and no closure of the visceral peritoneum. Partial dehiscence was found at 3 (1.47%) of 204 patients included in this study and total dehiscence was not found in any case. There was no significant association between the presence of dehiscence and the time from previous caesarean section (p=0.76). Bladder adhesions were found in 11.37% of cases, omental adhesions in 4.19% of cases and intestinal adhesions had not been found at all. We noticed that in 86.22% the pelvic/abdominal cavity was free of adhesions. No significantly association between the presence of adhesions and the time from the previous caesarean section was found (p=0.45). Single layer uterine closure is a safe technique with a very low risk in terms uterine scar dehiscence and adhesions formation.
DOI:10.18643/gieu.2013.11

Keywords: caesarean section, single layer uterine closure, visceral peritoneum, adhesions formation