{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:28:28Z","timestamp":1773415708357,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the ultrasonographic features of uterine scars and clinical symptoms after cesarean delivery (CD) using barbed and conventional smooth sutures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This case\u2013control study enrolled women who underwent primary CD at 37\u2009weeks of pregnancy or later. The uterus was closed using either double\u2010layer unidirectional barbed suture or conventional double\u2010layer smooth suture. Ultrasound scans of the uterine scar and evaluations of menstrual patterns were performed at 6, 12, and 24\u2009months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 102 patients underwent uterine closure with barbed suture, while 135 patients underwent smooth suture. At 6\u00a0months, patients in the barbed group had a lower incidence of uterine niches (20.2% vs 32.6%) that were also shallower in depth (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Lower incidence of niches was also observed in the barbed group at 12 and 24\u2009months (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.043 and 0.048, respectively). At these two follow\u2010up times, the smooth group had a higher number of patients reporting postmenstrual spotting (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) and more postmenstrual spotting days per month (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.050).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of double\u2010layer barbed suture during CD was associated with a lower incidence of scar niches and a more favorable menstrual pattern compared with the use of smooth suture.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14744","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T07:53:56Z","timestamp":1677225236000},"page":"895-905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Incidence and ultrasonographic characteristics of cesarean scar niches after uterine closure by double\u2010layer barbed suture: A prospective comparative study"],"prefix":"10.1002","volume":"162","author":[{"given":"Franco","family":"Alessandri","sequence":"first","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"Centurioni","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Perrone","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Evangelisti","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Urso","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Paratore","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Guida","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Nappini","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Gustavino","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2225-5568","authenticated-orcid":false,"given":"Simone","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) University of Genoa  Genoa Italy"},{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-6603","authenticated-orcid":false,"given":"Fabio","family":"Barra","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31928-7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002494"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e318263c699"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.01.037"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13199"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2021.0195"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19049"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17401"},{"issue":"3","key":"e_1_2_10_10_1","first-page":"82","article-title":"The use of barbed sutures in obstetrics and gynecology","volume":"3","author":"Greenberg JA","year":"2010","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14080"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2010.06.007"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-021-06121-8"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24953"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12542"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14209"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2015.02.018"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.18236"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2008.06.004"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.12.023"},{"issue":"12","key":"e_1_2_10_21_1","first-page":"2695","article-title":"Why do niches develop in cesarean uterine scars? Hypotheses on the etiology of niche development","volume":"30","author":"Vervoort AJ","year":"2015","journal-title":"Hum Reprod"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.05.067"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100592"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14509"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2022.05.001"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16472"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14744","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.14744","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14744","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T07:16:42Z","timestamp":1699946202000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.14744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/ijgo.14744"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.14744","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,15]]},"assertion":[{"value":"2023-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}