Lower Uterine Segment Following a Cesarean Section With Barbed Suture

Study Overview
=================
Brief Summary
-----------------
This aim of this study is to investigate the LUS in the pregnancy following a previous cesarean section with the use of barbed or conventional smooth suture.

Detailed Description
-----------------
To better assess the risk of uterine rupture, some authors have proposed sonographic measurement of lower uterine segment (LUS) thickness near term, assuming that there is an inverse correlation between LUS thickness and the risk of uterine scar defect. Recently, barbed suture has been employed for closing uterine wall after cesarean section, demonstrating the reduction of closure time of the uterine incision and estimated blood loss. Until now, the impact of barbed suture in future pregnancies has not been investigated.

Official Title
-----------------
Lower Uterine Segment at the Next Pregnancy Following a Cesarean Section With Barbed Suture: an Observational Prospective Comparative Study

Conditions
-----------------
Cesarean Wound; Dehiscence, Cesarean Section Complications

Intervention / Treatment
-----------------
* Procedure: Transvaginal ultrasound in the third trimester pregnancy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: pregnant women being undergone a previous elective cesarean section at term of pregnancy (more than 37 weeks of gestation), in which barbed or conventional smooth suture was used for closing anterior uterine wall Exclusion Criteria: having done more than one cesarean section having done a previous urgent cesarean section having done previous uterine surgical procedures with exception than one cesarean section

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pregnant women who underwent previous cesarean section with barbed suture<br>This group includes pregnant women, who underwent a previous cesarean section. During the previous surgical procedure, the hysterotomy was closed by using barbed suture (Fish-bone suture). | Procedure: Transvaginal ultrasound in the third trimester pregnancy<br>* Ultrasonographic transvaginal exam in patients at third trimester pregnancy (34-38 weeks of gestation)<br>|
| Pregnant women who underwent previous cesarean section with conventional smooth suture<br>This group includes pregnant women, who underwent a previous cesarean section. During the previous surgical procedure, the hysterotomy was closed conventional smooth suture. | Procedure: Transvaginal ultrasound in the third trimester pregnancy<br>* Ultrasonographic transvaginal exam in patients at third trimester pregnancy (34-38 weeks of gestation)<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ultrasonographic measure of lower uterine segment thickness | Measure of lower uterine thickness (mm) at transvaginal ultrasound | 34-38 weeks following study enrollment | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
barbed suture, uterine lower segment, cesarean section