Evaluation of Cesarean Scar Following Double Uterine Closure Including Upper Flap of Peritoneum Compared to Double Closure without Peritoneum
Rezk, A., El Mantwe, A., Negm, A., Ahmed, A. (2025). Evaluation of Cesarean Scar Following Double Uterine Closure Including Upper Flap of Peritoneum Compared to Double Closure without Peritoneum. EKB Journal Management System, 42(5), 95-103. doi: 10.21608/bmfj.2024.316480.2185
Ahmed Yousef Rezk; Ashraf Nassif El Mantwe; Aziza Ali Negm; Asmaa Gamal Ahmed. "Evaluation of Cesarean Scar Following Double Uterine Closure Including Upper Flap of Peritoneum Compared to Double Closure without Peritoneum". EKB Journal Management System, 42, 5, 2025, 95-103. doi: 10.21608/bmfj.2024.316480.2185
Rezk, A., El Mantwe, A., Negm, A., Ahmed, A. (2025). 'Evaluation of Cesarean Scar Following Double Uterine Closure Including Upper Flap of Peritoneum Compared to Double Closure without Peritoneum', EKB Journal Management System, 42(5), pp. 95-103. doi: 10.21608/bmfj.2024.316480.2185
Rezk, A., El Mantwe, A., Negm, A., Ahmed, A. Evaluation of Cesarean Scar Following Double Uterine Closure Including Upper Flap of Peritoneum Compared to Double Closure without Peritoneum. EKB Journal Management System, 2025; 42(5): 95-103. doi: 10.21608/bmfj.2024.316480.2185

Evaluation of Cesarean Scar Following Double Uterine Closure Including Upper Flap of Peritoneum Compared to Double Closure without Peritoneum

Benha Medical Journal
Article 675, Volume 42, Issue 5, May 2025, Page 95-103  XML PDF (487.83 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2024.316480.2185
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Authors
Ahmed Yousef Rezk1; Ashraf Nassif El Mantwe2; Aziza Ali Negm2; Asmaa Gamal Ahmed email 3
1Professor of Obstetrics and Gynecology, Faculty of Medicine, Benha University
2Associate Professor of Obstetrics and Gynecology, Faculty of Medicine, Benha University
3(M.B.B.Ch, Faculty of Medicine, Resident at Menouf General Hospital)
Abstract
Background: Cesarean scar defects (CSD) are associated with significant maternal morbidity, yet the impact of different uterine closure techniques on CSD formation remains underexplored. This study evaluates the effect of double uterine closure with and without the inclusion of the upper peritoneal flap on CSD size and residual myometrial thickness (RMT). This study aims to compare the residual myometrial thickness and the size of the cesarean scar defect following double-layer uterine closure with and without the inclusion of the upper peritoneal flap. Methods: This double-blind, prospective observational study included 70 women undergoing primary cesarean section at term. Participants were randomly assigned to two groups: Group A (n=35) received double-layer uterine closure without peritoneal inclusion, and Group B (n=35) received closure with peritoneal inclusion. Transvaginal ultrasonography was used to measure CSD size and RMT at 1, 3, and 6 months postoperatively. Results: At 6 months, Group B demonstrated significantly smaller CSD size (2.95±0.58 mm vs. 3.51±0.76 mm, p=0.04) and greater RMT (5.65±0.7 mm vs. 4.95±0.8 mm, p=0.02) compared to Group A. ROC curve analysis revealed a CSD size cut-off of
Keywords
Cesarean scar; double uterine closure; upper flap of peritoneum
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