Babu Km, Magon Navneet
Department of Obstetrics and Gynecology, Air Force Hospital, Gorakhpur, India.
N Am J Med Sci. 2012 Aug;4(8):358-61. doi: 10.4103/1947-2714.99519.
Fear of scar rupture is one of risks involved in a post caesarean pregnancy. This had led to an increased rate of repeat cesarean delivery in today's times. Closure of the uterine incision is a key step in cesarean section, and it is imperative that an optimal surgical technique be employed for closing a uterine scar. This technique should be able to withstand the stress of subsequent labor. In the existing techniques of uterine closure, single or double layer, correct approximation of the cut margins, that is, decidua-to-decidua, myometrium to myometrium, serosa to serosa is not guaranteed. Also, there are high chances of inter surgeon variability. It was felt that if a suturing technique which ensures correct approximation of all the layers mentioned above with nil or minimal possibility of inter operator variability existed, there will not be any thinning of lower segment caesarean section (LSCS). Further, a scarred uterus repaired in this manner will be able to withstand the stress of labor in future. We hereby report a new technique for uterine closure devised by us, which incorporates a continuous modified mattress suture technique as a modification of the existing surgical technique of uterine closure.
害怕瘢痕破裂是剖宫产术后再次妊娠所涉及的风险之一。这导致了当今重复剖宫产率的上升。子宫切口的缝合是剖宫产的关键步骤，采用最佳手术技术缝合子宫瘢痕至关重要。该技术应能够承受后续分娩的压力。在现有的子宫缝合技术中，无论是单层还是双层，都不能保证切缘正确对合，即蜕膜对蜕膜、肌层对肌层、浆膜对浆膜。此外，外科医生之间的差异很大。人们认为，如果存在一种缝合技术，能够确保上述所有层次正确对合，且手术者之间差异为零或最小，那么下段剖宫产（LSCS）就不会出现任何变薄的情况。此外，以这种方式修复的瘢痕子宫将能够承受未来分娩的压力。我们在此报告一种我们设计的子宫缝合新技术，它采用连续改良褥式缝合技术，作为对现有子宫缝合手术技术的改进。
