Cesarean Scar Defects After Uterine Closure by Double-layer Barbed or Smooth Suture
A Prospective Pilot Study Comparing Incidence and Characteristics of Cesarean Scar Defects After Uterine Closure by Double-layer Barbed or Smooth Suture
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Genoa, Italy, 16132
- IRCCS Ospedale Policlinico San Martino
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients who underwent elective cesarean section at ≥ 37 weeks of gestation
Exclusion Criteria:
- Patients who underwent concomitant surgical procedures during the cesarean section (i.e., tubal sterilization);
- Patients who underwent a previous abdominal surgery (with exception of appendectomy) including a cesarean section or other laparotomic/laparoscopic uterine surgical procedure (i.e., myomectomy);
- Patients who had a previous diagnosis of Mullerian uterine anomalies elective cesarean for the second time or after uterine surgery;
- Patients who had evidence of PAS disorders or placenta previa.
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Low transverse hysterotomy closed by double-layer unidirectional barbed suture
Patients who had undergone cesarean section during which the low transverse hysterotomy was closed by double-layer unidirectional barbed suture
|
Routinely assessment by objective examination and transvaginal ultrasonographic scan 6, 12, and 24 months after the surgical procedures
|
|
Low transverse hysterotomy closed by conventional double-layer smooth suture
Patients who had undergone cesarean section during which the low transverse hysterotomy was closed by conventional double-layer smooth suture
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Routinely assessment by objective examination and transvaginal ultrasonographic scan 6, 12, and 24 months after the surgical procedures
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of uterine scar defects
Time Frame: 6 months after the cesarean section
|
Number of simple and complex uterine scar defects is evaluated by transvaginal ultrasound
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6 months after the cesarean section
|
|
Number of uterine scar defects
Time Frame: 12 months after the cesarean section
|
Number of simple and complex uterine scar defects is evaluated by transvaginal ultrasound
|
12 months after the cesarean section
|
|
Number of uterine scar defects
Time Frame: 24 months after the cesarean section
|
Number of simple and complex uterine scar defects is evaluated by transvaginal ultrasound
|
24 months after the cesarean section
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Residual myometrium thickness (RMT), depth, width and length of uterine scar defects
Time Frame: 6 months after the cesarean section
|
RMT, depth, width, and length are evaluated by transvaginal ultrasound
|
6 months after the cesarean section
|
|
Residual myometrium thickness (RMT), depth, width and length of uterine scar defects
Time Frame: 12 months after the cesarean section
|
RMT, depth, width, and length are evaluated by transvaginal ultrasound
|
12 months after the cesarean section
|
|
Residual myometrium thickness (RMT), depth, width and length of uterine scar defects
Time Frame: 24 months after the cesarean section
|
RMT, depth, width, and length are evaluated by transvaginal ultrasound
|
24 months after the cesarean section
|
|
Number of patients with postmenstrual spotting
Time Frame: 6 months after the cesarean section
|
Number of patients with postmenstrual spotting is evaluated by medical interview
|
6 months after the cesarean section
|
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Number of patients with postmenstrual spotting
Time Frame: 12 months after the cesarean section
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Number of patients with postmenstrual spotting is evaluated by medical interview
|
12 months after the cesarean section
|
|
Number of patients with postmenstrual spotting
Time Frame: 24 months after the cesarean section
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Number of patients with postmenstrual spotting is evaluated by medical interview
|
24 months after the cesarean section
|
|
Number of patients with dysmenorrhea
Time Frame: 6 months after the cesarean section
|
Number of patients with dysmenorrhea is evaluated by medical interview with VAS (visual analogue scale)
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6 months after the cesarean section
|
|
Number of patients with dysmenorrhea
Time Frame: 12 months after the cesarean section
|
Number of patients with dysmenorrhea is evaluated by medical interview with VAS (visual analogue scale)
|
12 months after the cesarean section
|
|
Number of patients with dysmenorrhea
Time Frame: 24 months after the cesarean section
|
Number of patients with dysmenorrhea is evaluated by medical interview with VAS (visual analogue scale)
|
24 months after the cesarean section
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Fabio Barra, MD, IRCCS Ospedale Policlinico San Martino
Publications and helpful links
General Publications
- Agarwal S, D'Souza R, Ryu M, Maxwell C. Barbed vs conventional suture at cesarean delivery: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2021 Jun;100(6):1010-1018. doi: 10.1111/aogs.14080. Epub 2021 Feb 5.
- Alessandri F, Evangelisti G, Centurioni MG, Gustavino C, Ferrero S, Barra F. Fishbone double-layer barbed suture in cesarean section: a help in preventing long-term obstetric sequelae? Arch Gynecol Obstet. 2021 Sep;304(3):573-576. doi: 10.1007/s00404-021-06121-8.
- Jordans IPM, de Leeuw RA, Stegwee SI, Amso NN, Barri-Soldevila PN, van den Bosch T, Bourne T, Brolmann HAM, Donnez O, Dueholm M, Hehenkamp WJK, Jastrow N, Jurkovic D, Mashiach R, Naji O, Streuli I, Timmerman D, van der Voet LF, Huirne JAF. Sonographic examination of uterine niche in non-pregnant women: a modified Delphi procedure. Ultrasound Obstet Gynecol. 2019 Jan;53(1):107-115. doi: 10.1002/uog.19049.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- BARB-CSCAR
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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