scholarly journals Purse-string double-layer closure: A novel technique for repairing the uterine incision during cesarean section

2014 ◽  
Vol 41 (4) ◽  
pp. 565-574 ◽  
Author(s):  
Cem Turan ◽  
Esra Esim Büyükbayrak ◽  
Aylin Onan Yilmaz ◽  
Yasemin Karageyim Karsidag ◽  
Meltem Pirimoglu
Author(s):  
Aditya Prabawa ◽  
A A Ngurah Jayakusuma ◽  
A A Gede P. Wiradnyana

Objective : To compare cesarean scar defect incidence and other parameters between Turan technique and Conventional techniqueMethod : Literature ReviewResult : The Turan technique uses a purse-string double-layer closure method, which can shorten the incision length and reduce the incidence of postpartum cesarean scar defect that can be detected by ultrasound. Uterine incisional defects are etiologic factor of postoperative pelvic adhesion, placenta previa and accreta, uterine rupture, abnormal uterine bleeding and dysmenorrhea. This means that decrease in the incidence of uterine incisional defects is essential to prevent cesarean-related complications. In 51 patients in the study group (closure the uterine incision with Turan technique) and 65 patients in the control group collected within 6 weeks postoperative for transvaginal ultrasound, the length of the uterine incision closure in the study group shorter than control group (p= 0.0001, 95% IK = 2,854-6,876). Significantly, the number of patients with cesarean scar defect was 12 (23.5%) in the study group and 39 in the control group (76.5%) with P = 0.0001.Conclusion : Turan technique is new uterine closure method technique on CS. This technique can reduce the incidence of cesarean scar defect.Keyword : Turan Technique, Cesarean Section, uterine incision Abstrak Tujuan : Untuk membandingkan angka kejadian defek jaringan parut uterus dan parameter lain antara teknik Turan dan teknik konvensionalMetode : Kajian PustakaHasil : Teknik Turan menggunakan metode penutupan purse-string double layer, dimana dapat memperpendek insisi dan mengurangi insidensi defek jaringan parut uterus postpartum yang dapat dideteksi dengan ultrasonografi. Defek insisional uterus merupakan faktor etiologi dari adhesi pelvis paska operasi, plasenta previa dan akreta, ruptur uteri, kehamilan ektopik pada parut uterus, perdarahan uterus abnormal dan dismenore. Ini berarti penurunan kejadian defek insisional uterus sangat penting untuk mencegah terjadinya komplikasi terkait seksio sesarea. Pada 51 pasien kelompok studi (teknik Turan) dan 65 pasien pada kelompok kontrol yang dilakukan pemeriksaan ultrasonografi transvaginal 6 minggu paska operasi didapatkan data bahwa panjang insisi uterus lebih pendek pada kelompok studi (P = 0.0001, 95% IK = 2.854–6.876). Secara signifikan, jumlah pasien dengan defek parut bekas operasi (Cesarean Scar Defect) adalah 12 orang (23.5%) pada kelompok studi dan 39 orang pada kelompok kontrol (76.5%) dengan nilai P = 0.0001Kesimpulan : Teknik Turan adalah teknik baru mengenai metode penjahitan pada insisi operasi SC. Secara signifikan tehnik ini mampu menurunkan insidensi defek parut bekas operasi.Kata kunci : Teknik Turan, Seksio Sesarea, Insisi uterus  


2007 ◽  
Vol 197 (6) ◽  
pp. S77
Author(s):  
Yair Blumenfeld ◽  
Aaron Caughey ◽  
Yasser El-Sayed ◽  
Kay Daniels ◽  
Deirdre Lyell

Author(s):  
Franco Alessandri ◽  
Giulio Evangelisti ◽  
Maria Grazia Centurioni ◽  
Claudio Gustavino ◽  
Simone Ferrero ◽  
...  

Author(s):  
Ismail Biyik ◽  
Fatih Keskin ◽  
Elif Keskin

AbstractPlacenta accreta syndromes are associated with increased maternal mortality and morbidity. Cesarean hysterectomy is usually performed in cases of placenta accreta syndrome. Fertility sparing methods can be applied. In the present study, we report a successful segmental uterine resection method for placenta accreta in the anterior uterine wall in a cesarean section case. A 39-year-old woman underwent an elective cesarean section at 38 + 2 weeks. A placental tissue with an area of 10 cm was observed extending from the anterior uterine wall to the serosa, 2 cm above the uterine incision line. The placental tissue was removed with the help of monopolar electrocautery. The uterine incision was continuously sutured. The patient was discharged on the second postoperative day. The placental pathology was reported as placenta accreta. The American College of Obstetricians and Gynecologists (ACOG) generally recommends cesarean section hysterectomy in cases of placenta accreta because removal of placenta associated with significant hemorrhage. Conservative and fertility sparing methods include placenta left in situ, cervical inversion technique and triple-P procedure. There are several studies reporting that segmental uterine resection is performed with and without balloon placement or artery ligation. Segmental uterine resection may be an alternative to cesarean hysterectomy to preserve fertility or to protect the uterus in cases of placenta accreta when there is no placenta previa.


F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 267 ◽  
Author(s):  
Werner M Neuhausser ◽  
Laxmi V Baxi

We present here a case of vasa previa in a multipara, diagnosed at the time of her late second trimester ultrasonogram. The patient subsequently underwent an elective cesarean section after 37 weeks gestation, giving birth to a healthy child with an uneventful post-partum, neonatal and infant course. At the time of cesarean section, the incision was gradually deepened in layers through the myometrium by utmost care allowing the amniotic sac to protrude through the uterine incision hereby avoiding laceration of the vasa previa and its branches. Fetal exsanguination and a need for blood transfusion as well as a possible adverse neonatal course were therefore avoided.


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