{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T22:49:10Z","timestamp":1779230950753,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,10,9]],"date-time":"2016-10-09T00:00:00Z","timestamp":1475971200000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>It is unclear whether hysterotomy closure techniques can affect niche development. Therefore, this study aimed to analyze the effect of single\u2010layer and double\u2010layer interrupted closures of hysterotomy incisions during primary cesarean section on the formation of uterine niches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A prospective cohort study of women undergoing primary cesarean section was performed between June 2011 and July 2014. Saline contrast sonohysterography was used to measure the niche depth and residual myometrium. The ratio of the niche depth to the sum of the niche depth and residual myometrium thickness (niche ratio) was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Niches were identified in 14\/58 (24.1%) women with single\u2010layer sutures and 55\/209 (26.3%) women with double\u2010layer sutures (<jats:italic>p<\/jats:italic> = 0.74). Single\u2010layer closure was associated with more than a five\u2010fold increase in the odds of a niche ratio \u22650.4 (odds ratio 5.59; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.71\u201318.28).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Single\u2010layer closure may be associated with an increased risk of larger niches (niche ratio \u22650.4), although it may not increase the overall frequency of niche formation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13015","type":"journal-article","created":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T15:12:48Z","timestamp":1473693168000},"page":"1352-1358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Comparison of the primary cesarean hysterotomy scars after single\u2010 and double\u2010layer interrupted 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