Original Articles

Vol. 48 No. 3 (2024): Cerrahpaşa Medical Journal

The Effect of Uterine Closure Methods During Cesarean Section on Isthmocele Development

Main Article Content

Shamsi Mehdiyev
Kübra Hamzaoğlu Canbolat
İpek Betül Özçivit Erkan
Mahmut Öncül
Burçin Karakuş
İsmail Çepni

Abstract

Objective: Isthmocele is frequently encountered due to the increasing rates of cesarean deliveries nowadays. This study aims to evaluate the effectiveness of uni-layer and dual-layer uterine closure techniques in preventing isthmocele formation 6 months post-cesarean delivery.



Methods: This retrospective study involved 57 women aged 18-35 who had planned cesarean sections after 38 gestational weeks with singleton pregnancies at our hospital between 2019 and 2020. Patients were categorized into 2 groups based on the uterine closure method used during the cesarean sections: uni-layer technique vs. dual-layer technique. The main outcome was the incidence of isthmocele formation at the post-operative 6th month. Secondary outcomes included the remaining myometrial thickness and posterior uterine wall thickness at the 6-month follow-up.



Results: At the 6-month post-cesarean section follow-up, ultrasound revealed isthmocele formation in 17 patients (60.7%) in the uni-layer group and 6 patients (20.6%) in the dual-layer group. The remaining myometrial thickness (RMT) was 5.7 ± 1.4 mm in the uni-layer group and 6.5 ± 1.4 mm in the dual-layer group (P = .04). Remaining myometrial thickness and posterior uterine wall thickness were positively correlated.



Conclusion: The isthmocele development was significantly affected by the uterine closure method. The dual-layer closure method can be used to reduce the risk of isthmocele development.



Cite this article as: Mehdiyev S, Hamzaoğlu Canbolat K, Özçivit Erkan İB, Öncül M, Karakuş B, Çepni I. The effect of uterine closure methods during cesarean section on isthmocele development. Cerrahpaşa Med J. 2024;48(3):267-271.


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