Comparison of Purse String Suture vs Transverse Mattress Suture to Maintain Hemostasis in Thinned-out Caesarean Sections Scars

August 10, 2026 updated by: Natasha Bushra

Brief Summary The goal of this clinical trial is to compare the effectiveness of purse-string suture versus transverse mattress suture for achieving hemostasis in women with thinned-out lower uterine segment scars undergoing repeat cesarean section. The study aims to determine whether the purse-string suture technique provides faster and more effective hemostasis than the transverse mattress suture technique.

The main questions it aims to answer are:

  • Does the purse-string suture reduce the time required to achieve hemostasis compared with the transverse mattress suture?
  • Does the purse-string suture reduce the number of additional sutures required to achieve adequate hemostasis? Researchers will compare purse-string suturing with transverse mattress suturing to determine which technique achieves hemostasis more efficiently in women with thinned-out cesarean section scars.

Participants will:

  • Undergo repeat cesarean section under standard surgical care.
  • Be randomly assigned to receive either purse-string suturing or transverse mattress suturing for repair of the thinned-out lower uterine segment after closure of the first uterine layer.
  • Have the time required to achieve hemostasis and the number of sutures required recorded intraoperatively.
  • Receive routine postoperative management according to institutional protocols. Suggested improvement

Although the thesis mentions only time to achieve hemostasis and number of sutures as outcomes, ClinicalTrials.gov prefers that the primary outcome be clearly identified. Since your sample size was calculated using time to achieve hemostasis, I recommend presenting it as:

  • Primary outcome: Time to achieve hemostasis (minutes)
  • Secondary outcomes: Number of sutures required for hemostasis; duration of cesarean section (minutes)

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54070
        • Lahore General Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Females aged 18 to 40 years.
  • Gestational age >37 weeks at the time of delivery.
  • Parity <5.
  • History of one or more previous cesarean sections.
  • Intraoperative evidence of a thinned-out lower uterine segment scar during repeat cesarean section.

Exclusion Criteria:

  • Preeclampsia (blood pressure ≥140/90 mmHg with proteinuria >+1 on dipstick).
  • Gestational diabetes mellitus.
  • Placental abnormalities, including placenta previa, placenta accreta spectrum (accreta/increta), or placental abruption.
  • Previous uterine repair scar.
  • Coagulation disorder (prothrombin time >15 seconds).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm 1 Arm Title: Purse-String Suture
Participants undergoing repeat cesarean section with a thinned-out lower uterine segment scar underwent uterine repair using the purse-string suture technique to achieve hemostasis.
Procedure: Purse-String Suture
Purse-string suturing of the thinned-out lower uterine segment during repeat cesarean section.
Experimental: Arm 2 Arm Title: Transverse Mattress Suture
Participants undergoing repeat cesarean section with a thinned-out lower uterine segment scar underwent uterine repair using the transverse mattress suture technique to achieve hemostasis.
Procedure: Transverse Mattress Suture
Transverse mattress suturing of the thinned-out lower uterine segment during repeat cesarean section.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to Achieve Hemostasis
Time Frame: During the surgical procedure (intraoperative)
Time (in minutes) required to achieve complete hemostasis of the thinned-out lower uterine segment following application of the assigned suturing technique during repeat cesarean section.
During the surgical procedure (intraoperative)
Time to Achieve Hemostasis
Time Frame: Intraoperative (during cesarean section)
Time (in minutes) required to achieve complete hemostasis of the thinned-out lower uterine segment following application of the assigned suturing technique during repeat cesarean section.
Intraoperative (during cesarean section)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Sutures Required to Achieve Hemostasis
Time Frame: Intraoperative (during cesarean section)
Number of hemostatic sutures required to achieve complete hemostasis of the thinned-out lower uterine segment during repeat cesarean section.
Intraoperative (during cesarean section)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Natasha Bushra

Collaborators

Lahore General Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 6, 2026

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

August 6, 2026

First Submitted That Met QC Criteria

August 10, 2026

First Posted (Actual)

August 11, 2026

Study Record Updates

Last Update Posted (Actual)

August 11, 2026

Last Update Submitted That Met QC Criteria

August 10, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • lahore general hospital
  • irb no 199/24 (Other Identifier: lahore general hospital)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to institutional and ethical restrictions and the absence of a predefined data-sharing plan.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe