The use of barbed suture for uterine incision closure at cesarean section is associated with shorter uterine closure time and similar early perioperative complications compared with conventional smooth suture. The difference between both groups in the technique of suturing the second layer of the uterine incision may be the cause of the reduction in the uterine closure time and the need for additional sutures to achieve hemostasis during suturing the uterine incision with a barbed suture. Further, well designed randomized controlled trials should be conducted to investigate the association between the type of suture (barbed or conventional smooth) and remote complications of cesarean section (infertility, pelvic pain, abnormal placentation and rupture uterus).

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A Doppler flow study of the uterine artery was performed using transvaginal sonography in 68 women, including 44 using an intrauterine contraceptive device (IUCD) and 24 control women who were not using any method of contraception. Both the pulsatility index (PI) and resistance index (RI) were significantly lower in women with IUCD-induced bleeding than in those without abnormal vaginal bleeding (p < 0.001) or in women not using any method of contraception (p < 0.001). No significant variations in PI and RI levels (p > 0.05) were found with the duration of IUCD application or the duration of IUCD-induced bleeding in patients using the device. Also, no significant changes in blood flow indices were demonstrated between women using the device without abnormal vaginal bleeding and the control group. These preliminary results suggest that some women are more prone to develop IUCD-induced bleeding than others, and this bleeding may be due to decreased vascular resistance in the uterine artery. Transvaginal Doppler study of the uterine artery may be a helpful technique to identify such women.