Effect of Single Layer and Double Layer Uterine Closure On Uterine Niche Volume in 3D Ultrasound in Patients with First C-Section

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Calis P., BAYRAM M., Karcaaltincaba D.

GAZI MEDICAL JOURNAL, no.3, pp.279-281, 2019 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2019
  • Doi Number: 10.12996/gmj.2019.69
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Page Numbers: pp.279-281
  • Gazi University Affiliated: Yes


Introduction: Niche is defined as a gap in myometrium in ultrasound due to previous caesarean section. The most seen complication is postmenstrual spotting. Uterine rupture and invasive placenta in future pregnancy could also occur. Niche volumes could change according to suture technique for uterine closure. Material Method: Prospective, case control study was designed in Gazi University Faculty of Medicine Department of Obstetrics and Gynecology between September 2016 and september 2017. Patients were selected who had no previous uterine surgery. Half of the patients had single layer locked continuous and other half had double layer locked continuous suture. At postoperative 6th week, niche volume was calculated by 3D transvaginal ultrasound. Results: 21 patients had single layer, 33 had double layer uterine closure. The median volume values for single and double layer closure were 443,60 mm(3) and 66,53 mm3 respectively (p<0.001). Discussion: In the study, at 6th week postoperative period all patients had niche. Uterine niche volume in double layer closure was found to be less than single layer closure. Thus, double layer closure provides better uterine healing and expected to be associated with less long term morbidity.