Evaluation of the Correlation Between Preoperative Anterior Wall Myometrium Thickness and Uterine Closure Techniques in the Development of Uterine Scar Defect (Niche) After Previous Caesarean Section Geçirilmiş Sezaryen Sonrası Uterin Skar Defekti (Niş) Gelişiminde Preoperatif Anterior Duvar Myometrium Kalınlığı ve Uterus Kapatma Teknikleri Arasındaki Korelasyonun DeğerIendirilmesi

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Torun R., Şengül M., Demirel E., Ekmekci E., Kelekci S.

Anatolian Journal of General Medical Research, cilt.35, sa.1, ss.30-37, 2025 (Scopus, TRDizin)

Özet

Objective: The objective was to evaluate the correlation between the development of uterine scar defect (niche) following cesarean section, preoperative thickness of the anterior wall myometrium, and uterine closure techniques. Methods: In a prospective randomized study, the preoperative anterior myometrial thickness of 75 women scheduled for cesarean delivery was measured. Single and double-layer uterine closure techniques were employed during surgery. Patients were evaluated postoperatively in the 6th to 8th weeks using transvaginal ultrasonography for uterine niche. Results: No statistically significant correlation was found between preoperative anterior wall myometrial thickness and the height, area, base, and width of the niche identified by transvaginal ultrasonography. In the group undergoing double-layer continuous unlocked suture technique, the niche area was significantly larger (p=0.023). No statistical differences were found between preoperative hemoglobin (HB) and hematocrit (HCT) values, but postoperative 6th and 24th hour HB and HCT levels were significantly lower in patients with double-layer uterine closure (p<0.05). Conclusion: Selecting a continuous suturing technique without locking can significantly reduce the area of the developing uterine scar defect. Furthermore, postoperative declines in HB and HCT can be minimized. Although sufficient data has not yet been reached to clearly define an operation technique that reduces niche formation, further studies with larger series are needed.