title: Survey on uterine closure and other techniques for Caesarean section among Quebec's obstetrician-gynaecologists.
abstract: OBJECTIVE
  To evaluate the preferred types of uterine closure at Caesarean section among Quebec's obstetrician-gynaecologists.
  
  
  METHODS
  An anonymous survey with multiple-choice and open questions was sent by email to all members of the Association des Obstétriciens-Gynécologues du Québec in clinical practice. The primary response of interest was the type of uterine closure that would be favoured for a primigravida undergoing an elective CS at term for a breech fetus. Secondary responses of interest included type of uterine closure for CS performed for other indications, and methods of closure for the bladder flap, parietal peritoneum, rectus abdominis muscle, subcutaneous tissue, and skin. Results were stratified according to the number of years in practice.
  
  
  RESULTS
  Of 454 persons targeted, 176 (39%) responded. Responders were more likely to have fewer years in practice than the targeted population in general. The closures for a primigravida undergoing an elective CS at term for a breech presentation were, in order of preference: (1) a double-layer closure combining a first locked layer and an imbricating second layer (61%), (2) a double-layer closure combining a first unlocked layer and an imbricating second layer (28%), (3) a locked single layer (5%), (4) an unlocked single layer (5%), and (5) other techniques (1%). A locked single-layer closure was more frequently used for repeat CS (29%), and it was the favoured technique (40%) when tubal ligation was performed at the time of CS (P < 0.05).
  
  
  CONCLUSIONS
  Double-layer closure is the type of uterine closure most preferred by obstetricians in Quebec. However, the first layer is locked by two thirds of obstetricians and unlocked by the remainder.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City QC.
authors: Suzanne
authors: S
authors: Demers
authors: Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City QC.
authors: Stéphanie
authors: S
authors: Roberge
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City QC.
authors: Yamal A
authors: YA
authors: Afiuni
authors: Department of Obstetrics and Gynecology, University of Montreal, Montreal QC.
authors: Nils
authors: N
authors: Chaillet
authors: Department of Obstetrics and Gynecology, St-Mary's Hospital, McGill University, Montreal QC.
authors: Isabelle
authors: I
authors: Girard
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City QC.
authors: Emmanuel
authors: E
authors: Bujold
mesh_terms: D001946:Breech Presentation / Q000601:surgery; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D020073:Gravidity; D006801:Humans; D009774:Obstetrics / Q000379:methods*; D011247:Pregnancy; D011792:Quebec; D011795:Surveys and Questionnaires; D013997:Time Factors; D014599:Uterus / Q000601:surgery*
keywords: Caesarean section; closure; pregnancy; surgery; survey; uterus