The many ways to sew up a uterus. "Single-layer" vs. "double-layer" cesarean repair: what's best?
Some clinicians have used a single, poorly-designed, retrospective study of single-layer vs. double-layer repair of the uterus during cesarean surgery to justify denying women the option of a trial of labor on subsequent pregnancies. This paper reviews the latest research and suggests the adoption of four new protocols for women after a cesarean. Women should receive a full summary of the repair methods used during their surgery; Women should be counseled as to the risk of delivering another child less than two years after uterine surgery; On subsequent pregnancies after cesarean birth, women should have an ultrasound near the end of the pregnancy looking for evidence of placental growth in the area of the scar and implications of this should be explained; and Vicryl sutures should be used for sewing up the uterus.
Cohain
Judy Slome
JS
All the Way Homebirth practice, Israel.
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D017604:Cesarean Section, Repeat / Q000379:methods; D003657:Decision Making; D005260:Female; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods; D028701:Patient Rights; D011247:Pregnancy; D011256:Pregnancy Outcome; D011369:Professional-Patient Relations; D013536:Suture Techniques; D016064:Vaginal Birth after Cesarean / Q000379:methods; D016387:Women's Health