Comparison of kerr incision singleor double layer repair techniques with transvaginal ultrasonography in patients with primary cesarean section

It is seen that thefrequency of cesarean section is increasing in ourcountry, as in developed and developing countries. It has been recorded that approximately 21% of births were by cesarean section. It is understood that complications such as placental invasion anomaly and uterine rupture observed in subs equent pregnancies are directly proportional tothenumber of previous uterine surgery and cesarean delivery. The incidence of scar defect called isthmocele, which can be considered as pathological healingorin sufficiency of healing in the uterine incisionline, has increased. Considering the isthmocele and the obstetric and gynecological problems it causes, it is very important to understand the causes of isthmocele after cesarean section and to develop preventive techniques whene verpossible. The number of studies conductedfor this purpose is increasing day by day. In our study, it was planned to compare the effects of cesarean section and postpartum uterine closure techniques on scar defectand isthmocele formation with TVUSG. Fifty patients who applied to Gaziantep University Hospital Gynecologyand Obstetrics Clinic between January 2023 and May 2023 and were given an indication for elective or emergency cesarean section participated in thestudy. Those with a history of previous uterine surgery, preterm pregnancies before 37 weeks of gestation, placental invasion and localization anomaly were not included in thestudy. Fifty patients who met thecriteria were randomized into two groups. For randomization, patients were divided into two groups, in twos, by permutation method. In both groups, the abdomen was entered with a pfannensteil incision and the uterus with a kerr incision. Patients who underwent uterine repair with a single layer locking were included in group 1, those with uterine repair with double layer suturing were included in group 2. Between the 3rd and 6th months after the operation, the patients were called for control and cesarean scar and isthmocele formation were evaluated with TVUSG. All of the patients included in the study came for control and 50 patients were divided into two groups and compared with each other in terms of isthmocele development and scar tissue. There was nosignificant difference between the groups in terms of age, BMI, gestational week, and additional diseases. Isthmocele was observed more frequently in the single layer locked group than in the double layer group. There was nocomplain tdueto isthmocele in any of the patients. In patients with isthmocele, nopathology development was observed in the posterior myometrium layer. As a result of ourstudy, it was understood that the double layer closure method reduced the development of isthmocele and scar defect, and it was found to be statistically significant. It is predicted that beter results will be obtained by repairing the uterine defect with this method after cesarean section. However, it is understood that the most appropriate closure technique could not be clearly demon strated in previous studies. There as on forth ismay be that many factors other than uterine repair techniques are effective in the formation of isthmocele. Studies with a larger number of patients and strict standardization of additional features will be effective in determining the most appropriate technique. We believe that our study will give an idea to studies in the same direction. Keywords:Uterine closure method, cesarean section, isthmocele, scardefect.