The CAESAR trial and CORONIS trial evaluated techniques for cesarean section. Regarding uterine closure, which approach was found to be equivalent or preferable regarding re-entry difficulty and uterine scar thickness?

• A Single-layer locking uterine closure reduces adhesions compared to double-layer
• B Double-layer closure results in superior scar integrity compared to single-layer
• C Neither single nor double layer showed significant differences in long-term outcomes ✓
• D Blunt uterine entry is associated with higher blood loss than sharp entry

Explanation

The CAESAR and CORONIS trials (multi-arm RCTs of cesarean techniques) found that neither single-layer nor double-layer uterine closure showed significant differences in maternal outcomes or subsequent scar integrity. However, observational studies suggest that single-layer unlocked closure may be associated with thinner uterine scars and increased risk of scar defect (niche/caesarean scar defect). Current evidence from these RCTs does not support one technique over the other definitively.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.