Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

Abstract

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

Babu and Magon uterine closure technique during cesarean section: A randomized double‐blind trial

“…In line with our data, Vinayachandran et al reported that the duration of uterine closure by the Babu and Magon technique and blood loss were different from those associated with conventional closure, but the difference was not statistically significant. 25 As the main outcome of the present study, a niche was observed on TVU after 12-14 weeks in 37.5% of women. The rate of cesarean scar defects varies from 20% to 60% in the published literature.…”

“…The difference between the present study and Vinayachandran and coworkers' report appears to be due to differences in the study population: in the latter investigation, the indication for CS was elective and all women underwent CS before the onset of active labor. 25 In contrast, we performed 59.7% of CS (71% by the Babu and Magon technique vs 51% in controls) in the active phase of labor. We observed a significant relationship between CS in the active phase and the development of a niche.…”

“…Vinayachandran et al observed a mean residual myometrial thickness of 7.1 AE 2 mm when using the Babu and Magon closure technique, and 5.4 AE 1.7 mm in the conventional group. 25 The difference underlines the better quality of healing achieved by the Babu and Magon closure technique than the conventional method. 13 In the present study, the residual myometrial thickness was greater when using the Babu and Magon closure technique than the residual myometrial thickness reported in some studies when using the single and double-layer closure technique.…”