Re: One layer uterine closure
From: R. Daniel Braun (rd.braun@gmail.com)
Thu Sep 7 20:52:45 2006
If you read the whole article, you will find that the single layer closures
were all LOCKED sutures. This would make a big diference. The study needs
to be done comparing with UNLOCKED single layer.
Dan
On 9/7/06, Efrain Ramirez <eramirezt@coqui.net> wrote:
>
> At Thu, 7 Sep 2006, R. Daniel Braun wrote:
> >
> >OOOOOOOOHHHH!!!!!!!!!!!
> >Data???
> >
> >Dan
> The impact of a single-layer or double-layer closure on uterine rupture.
> Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ
>
> Am J Obstet Gynecol (2002 Jun) 186(6):1326-30 ISSN: 0002-9378
>
> Obstetric Surgical Procedures
> Uterine Rupture
> Cohort Studies
> Comparative Study
> Female
> Human
> Odds Ratio
> Pregnancy
> Recurrence
> Trial of Labor
>
> Abstract
>
> OBJECTIVE: Our purpose was to measure the impact of a single-layer or
> double-layer closure on uterine rupture at subsequent delivery.
>
> STUDY DESIGN: This is an observational cohort study of all women
> undergoing a trial of labor from 1988 to 2000 in a tertiary care center,
> after a single low transverse cesarean delivery. Factors most highly
> associated with uterine rupture were identified by using univariate
> regression analysis. Multivariate logistic regression analysis was used
> to adjust for selected confounding variables.
> Top of Abstract
> RESULTS: Of the 2142 women who met the study criteria, 1980 (92.4%) had
> maternal records and original operative reports reviewed. After
> adjustments were made for confounding variables, the odds ratio for
> uterine rupture in women with a single-layer closure was 3.95 (95% CI,
> 1.35- 11.49).
>
> CONCLUSION: A single-layer closure of the previous lower segment
> incision was the most influential factor and was associated with a
> 4-fold increase in the risk of uterine rupture compared with a
> double-layer closure.
>
> --
> R. Daniel Braun
>
> "The way to health is an aromatic bath and scented massage
> everyday".
> Hippocrates
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