title: Risk of uterine rupture following locked vs unlocked single-layer closure.
abstract: OBJECTIVE
  To compare the rate of uterine scar disruption after a locked versus an unlocked single-layer closure of the hysterotomy incision at a previous cesarean.
  
  
  METHODS
  A retrospective cohort study in a population where both locked and unlocked single-layer closure are commonly used. All singleton pregnancies at 24 weeks' gestation or more with a previous single cesarean were included. Rate of uterine scar disruption (complete uterine rupture and uterine scar dehiscence) were compared between women with a previous locked and those with a previous unlocked single-layer closure of the uterus.
  
  
  RESULTS
  Out of 388 women included in the study, 272 had a previous unlocked single-layer closure and 116 had a locked single-layer closure. We found no significant difference in the rate of uterine scar disruption between the two groups (5.9% vs 8.6%, p = 0.32).
  
  
  CONCLUSIONS
  Locking a single-layer closure was not associated with an increase rate of uterine scar disruption at the next pregnancy in our retrospective analysis. A randomized trial should be performed.
authors: Clinic for Gynecology and Obstetrics, University Clinical Center, Tuzla, Bosnia and Herzegovina. i.hudic@bih.net.ba
authors: Igor
authors: I
authors: Hudic
authors: Emmanuel
authors: E
authors: Bujold
authors: Zlatan
authors: Z
authors: Fatusic
authors: Stéphanie
authors: S
authors: Roberge
authors: Amer
authors: A
authors: Mandzic
authors: Jasenko
authors: J
authors: Fatusic
mesh_terms: D058107:Abdominal Wound Closure Techniques; D000328:Adult; D017604:Cesarean Section, Repeat; D005260:Female; D006801:Humans; D011247:Pregnancy; D012306:Risk; D013536:Suture Techniques / Q000009:adverse effects*; D014597:Uterine Rupture / Q000209:etiology*