{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T21:26:39Z","timestamp":1747344399119,"version":"3.37.3"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Our objective is to evaluate ultrasound differences in uterine scar between techniques using extramucosal suturing and full thickness suturing of the uterine incision.<\/jats:p><jats:p>\n            Study Design\u2003A retrospective observational study included cases of primary cesarean section. At 6-week postpartum, we evaluated by endovaginal ultrasound two elements in the sagittal view: the thickness of the uterine scar and the surface of defect (niche). Hysterotomy sites closed using a running full-thickness technique including the uterine mucosa (group 1) were compared to hysterotomies operated by the same surgeon but with extramucosal suturing (group 2). The operator switched from the running suture technique to extramucosal in 2013.<\/jats:p><jats:p>\n            Results\u2003The study included 241 patients (115 cases in group 1 that were compared to 126 cases in group 2). There were no significant differences in age or body mass index between the two groups. Cesarean scar and niche were detectable in the entire studied population. There was a significant difference in both uterine scar thickness (5.8 vs. 6.2\u2009mm, p\u2009=\u20090.02) and the presence and size of the niche (49 vs. 40\u2009mm2, p\u2009=\u20090.001) in transvaginal ultrasound performed at 6-week postpartum.<\/jats:p><jats:p>\n            Conclusion\u2003Extramucosal suturing of the uterine scar seems to be associated with a better outcome on the postpartum ultrasound evaluation.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2022-9892","type":"journal-article","created":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T23:55:46Z","timestamp":1675209346000},"page":"e1357-e1361","source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Uterine Scar Evaluation during the Postpartum: Pleading for Extradecidual Suturing during Cesarean Section"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8810-5493","authenticated-orcid":false,"given":"Assaad K.","family":"Kesrouani","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, St. Joseph University, Beirut, Lebanon"},{"name":"Department of Obstetrics and Gynecology, Hotel-Dieu de France University Hospital, Prenatal Unit, Bellevue Medical Center, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yara","family":"Abdelkhalek","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, St. Joseph University, Beirut, Lebanon"},{"name":"Department of Obstetrics and Gynecology, Hotel-Dieu de France University Hospital, Prenatal Unit, Bellevue Medical Center, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, St. Joseph University, Beirut, Lebanon"},{"name":"Department of Obstetrics and Gynecology, Hotel-Dieu de France University Hospital, Prenatal Unit, Bellevue Medical Center, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Chaccour","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, St. Joseph University, Beirut, Lebanon"},{"name":"Department of Obstetrics and Gynecology, Hotel-Dieu de France University Hospital, Prenatal Unit, Bellevue Medical Center, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inaam","family":"Hatoum","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Rafik Hariri University Hospital, Beirut, Lebanom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freda","family":"Richa","sequence":"additional","affiliation":[{"name":"Anesthesia Department, St. Joseph University, Hotel-Dieu de France University Hospital, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ejogrb.2005.03.023","article-title":"Incomplete healing of the uterine incision after caesarean section: is it preventable?","volume":"124","author":"F Yazicioglu","year":"2006","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1007\/s00404-021-06074-y","article-title":"Anatomy of the sonographic post-cesarean uterus","volume":"304","author":"A Al Naimi","year":"2021","journal-title":"Arch Gynecol Obstet"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/uog.999","article-title":"Cesarean section scar evaluation by saline contrast sonohysterography","volume":"23","author":"C Regnard","year":"2004","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1111\/1471-0528.15048","article-title":"Uterine caesarean closure techniques affect ultrasound findings and maternal outcomes: a systematic review and meta-analysis","volume":"125","author":"S I Stegwee","year":"2018","journal-title":"BJOG"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1080\/00016340500430436","article-title":"Methods for myometrium closure and other factors impacting effects on cesarean section scars of the uterine segment detected by the ultrasonography","volume":"85","author":"H Hayakawa","year":"2006","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"01","key":"ref6","first-page":"61","article-title":"Detection of cesarean scars by transvaginal ultrasound","volume":"101","author":"V Armstrong","year":"2003","journal-title":"Obstet Gynecol"},{"issue":"12","key":"ref7","first-page":"2695","article-title":"Why do niches develop in Caesarean uterine scars? Hypotheses on the aetiology of niche development","volume":"30","author":"A J Vervoort","year":"2015","journal-title":"Hum Reprod"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ejogrb.2016.08.032","article-title":"Standardized ultrasonographic approach for the assessment of risk factors of incomplete healing of the cesarean section scar in the uterus","volume":"205","author":"M Pomorski","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1002\/uog.6395","article-title":"High prevalence of defects in cesarean section scars at transvaginal ultrasound examination","volume":"34","author":"O V Osser","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1002\/uog.1033","article-title":"Sonographic imaging of cervical scars after Cesarean section","volume":"23","author":"E Z Zimmer","year":"2004","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"08","key":"ref11","first-page":"362","article-title":"The optimal uterine closure technique during cesarean","volume":"4","author":"E Bujold","year":"2012","journal-title":"N Am J Med Sci"},{"issue":"08","key":"ref12","doi-asserted-by":"crossref","first-page":"358","DOI":"10.4103\/1947-2714.99519","article-title":"Uterine closure in cesarean delivery: a new technique","volume":"4","author":"K Babu","year":"2012","journal-title":"N Am J Med Sci"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/uog.12479","article-title":"Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous cesarean section: a meta-analysis","volume":"42","author":"N Kok","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1055\/s-0032-1304829","article-title":"Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterine scar defect","volume":"29","author":"S Roberge","year":"2012","journal-title":"Am J Perinatol"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1002\/jum.15859","article-title":"The impact of uterine incision closure techniques on post-cesarean delivery niche formation and size: sonohysterographic examination of nonpregnant women","volume":"41","author":"C Antoine","year":"2022","journal-title":"J Ultrasound Med"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2022-9892.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:23:58Z","timestamp":1730813038000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2022-9892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,31]]},"references-count":15,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2022-9892","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2023,1,31]]},"published":{"date-parts":[[2023,1,31]]}}}