-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Single Layer vs Double Layer Uterine Closure From: viv souter (vsouter@yahoo.com) Fri Nov 7 07:37:54 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Braun, R. Daniel: "Re: Single Layer vs Double Layer Uterine Closure" Previous message: DoctorJoe@aol.com: "Re: Single Layer vs Double Layer Uterine Closure" In reply to: Braun, R. Daniel: "Re: Single Layer vs Double Layer Uterine Closure" I heard a pathologist talk recently and he said that in post mortem exams after LUSCS's the suture used to close the uterus is generally loose. He expressed concern that single layer closures were associated with an increased risk of accreta / percreta in future pregnancies. There do seem to be a lot more morbidly adherent placentas in the two USA centers that I have worked in compared to my experience in the UK (where a two layer closure is the norm). However I don't know if this (anecdotal) impression relects the high number of repeat CS's here in the USA and the associated increased risk of accreta with repeated CS delivery. Viv Souter "Braun, R. Daniel" <rbraun@iupui.edu> wrote: I place allis clamps on each angle. Then I start my suture lateral to one angle and finish up lateral to the other. I tie behind each allis. Dan -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of RModugno@aol.com Sent: Thursday, November 06, 2003 6:13 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Single Layer vs Double Layer Uterine Closure In a message dated 11/6/2003 5:17:23 PM Eastern Standard Time, eramirezt@coqui.net writes: At Thu, 6 Nov 2003, Braun, R. Daniel wrote: > >How important is it to close the uterus with a suture that persists? >Anybody gone back 24-48 hours post C/S and seen how loose that suture >is? The uterus begins to involute very rapidly and after 48 hours that >suture isn't holding much but empty space My main concerns are the uterine angles. I place a figure of 8 at the right angle under direct vision. Then start my new suture from the left angle as a figure of 8 - then run across to the other side as a continuous lock in a single layer and tie it to the right angle. Call me crazy :+) Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd.com Protect your identity with Yahoo! Mail AddressGuard Next message: Braun, R. Daniel: "Re: Single Layer vs Double Layer Uterine Closure" Previous message: DoctorJoe@aol.com: "Re: Single Layer vs Double Layer Uterine Closure" In reply to: Braun, R. Daniel: "Re: Single Layer vs Double Layer Uterine Closure"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Tue Dec 2 04:42:29 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.