loading page

Double-layered purse string uterine suture employing the French ambulatory cesarean section technique compared with single-layer continuous uterine suture: An ultrasound evaluation randomized trial.
  • +4
  • kaouther dimassi,
  • olivier ami,
  • rania merrai,
  • luka velemir,
  • benedicte simon,
  • denis fauck,
  • amel triki
kaouther dimassi
University of Tunis El Manar Faculty of Medicine of Tunis

Corresponding Author:[email protected]

Author Profile
olivier ami
Ramsay Healthcare France, La Muette, Paris, France
Author Profile
rania merrai
University of Tunis El Manar
Author Profile
luka velemir
Lenval foundation Polyclinique Santa Maria, Nice, France.
Author Profile
benedicte simon
Ramsay Healthcare France, Les Franciscaines, Versailles, France.
Author Profile
denis fauck
Ramsay Healthcare France, Saint Lambert, La Garenne-Colombes, France
Author Profile
amel triki
University of Tunis El Manar
Author Profile

Abstract

Objective: To test the hypothesis that compared to single layer continuous uterine suture (SLCUS), a double layered purse string uterine suture (PSUS) significantly reduces cesarean scar defect (CSD) rates, without increasing the perioperative maternal morbidity. Design : Interventional prospective, randomized study . Setting: University obstetric units in Tunisia. Population: 100 pregnant women with an indication of a planned Caesarean. Methods: Patients were enrolled in 2 groups according to the uterine suture technique: SLCUS or PSUS. A Saline infusion hysterosonography was performed by the same senior obstetrician blinded to the uterine suture technique 6 months after surgery . Main Outcome measures: Operative time and Calculated blood loss (CBL) were used for the short time analysis . Uterine and CSD measurements were used for the mid time analysis . Results : Despite a few minutes longer operative time in SUS group (7.17 ± 2.31 min Vs. 6.31 ± 3.04 min, p = 0.028 in SLCUS group; p <10‾³); there was no significant difference in terms of CBL (520 ± 58 in SUS group vs. 536 ± 50 ml in SLCUS group, p = 0.724). The medium-term analysis showed a significant decrease in the rate of CSD with the PSUS: 6.66% vs.40% with SLUCS; p = 0.002. Moreover, SLUCS was the leading risk factor for CSD : adjusted OR=6 ;95% CI [0- 1],p < 10‾³) . Conclusion : Compared to single layer continuous suture, purse string uterine suture significantly reduces cesarean scar defect rates, without increasing the perioperative maternal morbidity. NCT03930134. https://clinicaltrials.gov/ct2/show/NCT03930134