The CORONIS collaborative randomised trial assessed 5 caesarean section technical elements. Regarding uterine closure, the trial found that single-layer versus double-layer closure of the uterine incision resulted in:

• A Significantly higher uterine rupture rate in subsequent pregnancy with single-layer closure
• B Significantly shorter operating time with double-layer closure
• C Single-layer closure was superior in all outcomes
• D No significant difference in short-term maternal morbidity, but later scar thickness differed on ultrasound ✓

Explanation

The CORONIS trial (Lancet 2013) was a large factorial RCT examining five CS technical decisions. For uterine closure (single vs double layer), there was no significant difference in composite short-term maternal morbidity (blood transfusion, pyrexia, re-operation). However, observational data and separate meta-analyses suggest single-layer closure results in thinner lower uterine segment scar on subsequent pregnancy ultrasound, though the clinical significance for uterine rupture risk remains debated. The trial's primary endpoint showed equivalence in immediate morbidity.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.