{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T20:52:27Z","timestamp":1788641547607,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,7,26]],"date-time":"2011-07-26T00:00:00Z","timestamp":1311638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the best available evidence regarding the association between single\u2010layer closure and uterine rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched for relevant observational and experimental studies that included women with a previous single, low, transverse cesarean delivery who had attempted a trial of labor (TOL). The risks of uterine rupture and uterine dehiscence were assessed by pooled odds ratios (OR) calculated with a random effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine studies including 5810 women were reviewed. Overall, the risk of uterine rupture during TOL after a single\u2010layer closure was not significantly different from that after a double\u2010layer closure (OR 1.71; 95% confidence interval [CI] 0.66\u20134.44). However, a sensitivity analysis indicated that the risk of uterine rupture was increased after a locked single\u2010layer closure (OR 4.96; 95% CI 2.58\u20139.52, <jats:italic>P<\/jats:italic> &lt; 0.001) but not after an unlocked single\u2010layer closure (OR 0.49; 95% CI 0.21\u20131.16), compared with a double\u2010layer closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Locked but not unlocked single\u2010layer closures were associated with a higher uterine rupture risk than double\u2010layer closure in women attempting a TOL.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2011.04.013","type":"journal-article","created":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T02:27:10Z","timestamp":1311820030000},"page":"5-10","source":"Crossref","is-referenced-by-count":103,"title":["Single\u2010 versus double\u2010layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture"],"prefix":"10.1002","volume":"115","author":[{"given":"St\u00e9phanie","family":"Roberge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Chaillet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Boutin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Jastrow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Normand","family":"Brassard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Gauthier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Hudic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Shipp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte H.E.","family":"Weimar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zlatan","family":"Fatusic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Demers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Bujold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,7,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.03.063"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.07.023"},{"issue":"3","key":"e_1_2_6_4_2","first-page":"CD004732","article-title":"Surgical techniques for uterine incision and uterine closure at the time of caesarean section","author":"Dodd J.M.","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181df925f"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.119923"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2004.10.015"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(94)02306-J"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.1999.780709.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"crossref","unstructured":"CAESAR study collaborative group. 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