{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T20:52:28Z","timestamp":1788641548555,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,9,26]],"date-time":"2019-09-26T00:00:00Z","timestamp":1569456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study compared healing of the scars after cesarean section during the first postpartum year using a single\u2010 or double\u2010layer suturing technique. Scarring was assessed by a transvaginal ultrasound. We explored the appearance and localization of uterine scars with regard to the obstetric history. Our aim was to compare the position of the scar or defect, if present, its dimensions, and any residual myometrium with respect to the suturing technique during the cesarean section.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>Women with uncomplicated singleton pregnancies indicated for elective or acute cesarean section were randomly allocated to the uterine closure technique group. During the first postpartum year, their lower uterine segment was examined with a transvaginal ultrasound in three consecutive visits at 6\u00a0weeks, 6\u00a0months and 12\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>324 women attended the 12\u2010month visit; of these, 149 underwent single\u2010layer closure of the uterine incision and 175 double\u2010layer technique. A higher proportion of the defects is seen in the single\u2010layer closure technique of suturing. Defects in the single\u2010layer group were wider (0.002) and the residual myometrial thickness in the single\u2010layer group were thinner (0.019). Women who underwent cesarean section at the stage of full cervical dilation had scars that were closer to the external cervical os (0.000). The position of the uterus varies greatly between controls (0.000). The combination of uterine position and scar defect presence changed significantly between controls (0.001), and was significantly dependent on the suturing method (0.003). Defects with or without contact with the uterine cavity changed statistically between controls (0.017). Both types of defects were more common in the single\u2010layer closure technique group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings of this study demonstrate that double\u2010layer technique with the first continuous nonlocking suture followed by a second continuous nonlocking suture is associated with better suture healing and greater residual myometrial thickness. No difference was observed between single\u2010 and double\u2010layer closure for the presence of maternal infectious morbidity, wound infection or blood transfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.13714","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T06:43:52Z","timestamp":1566542632000},"page":"69-78","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Ultrasound cesarean scar assessment one\u00a0year postpartum in relation to one\u2010 or two\u2010layer uterine suture closure"],"prefix":"10.1111","volume":"99","author":[{"given":"Jiri","family":"Hanacek","sequence":"first","affiliation":[{"name":"Institute for the Care of Mother and Child Prague Czech Republic"},{"name":"3rd Medical Faculty Charles University Prague Czech 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