Objective: To compare residual myometrial thickness (RMT) and the size of the Cesarean scar defect after single compared to
double-layer uterine closure following elective Cesarean section by Transvaginal ultrasound and saline infusion sonography.
Background: Worldwide caesarean section (CS) delivery is the most common major operation. Saline infusion
Sonohystrography (SIS) has been used extensively to assess the uterine cavity in patients with suspected endometrial or
intracavitary disease in which transvaginal sonography alone fails to suggest a definitive diagnosis.
Patient and Methods: A prospective, randomized clinical study was conducted in the department of obstetrics and
gynecology, Menoufia University Hospital, Shebin El-kom, Egypt during September 2018 to December 2020.
Result: There was no statistically significant difference between single- and double-layer groups regarding age, gravidity,
parity, height, weight, BMI and gestational age (P>0.05). Also, there was no statistically significant difference between
single- and double-layer groups regarding type and indications of C.S (P>0.05). There was a statistically significant difference
between single- and double-layer groups regarding width of the defect, depth of the defect, fundal myometrial thickness and
RMT overlying the scar defect on ultrasound and Sonohystrography on the postoperative 6 months (P˂0.05). There was high
statistically significant correlation between Sonohystrography and width of the defect, depth of the defect, fundal myometrial
thickness, RMT on the postoperative 6 months (P<0.001),
Conclusion: Our results suggest that single-layer closure leads to smaller RMT compared with that following double-layer
closure and the difference was statistically significant, there was a statistically significant difference between single- and
double-layer groups regarding width of the defect, depth of the defect, fundal myometrial thickness and RMT overlying
the scar defect on both ultrasound and Sonohystrography on the postoperative 6 months. Also, there was high statistically
significant correlation between Sonohystrography and width of the defect, depth of the defect, fundal myometrial thickness,
RMT on the postoperative 6 months.