CLINICAL PRACTICE OF USING T. VEJNOVIC TECHNIQUE FOR SUTURE OF THE UTERUS AFTER CAESARIAN SECTION

Objective. To improve the outcomes of cesarean section using T. Vejnovic technique for suturing of the uterus after caesarean section. Materials and methods. The study included 220 women who underwent caesarean section to deliver their babies. They were divided into 3 groups: group 1 - the patients who had ceasarean section with the Pfannenstiel-Kerr technique; group 2 - the patients who had ceasarean section with M. Stark modified technique based on the Joel-Cohen incision; group 3 - the patients who had ceasarean section with M. Stark technique based on the Joel-Cohen incision, using T. Vejnovic modified uterine suture technique. Intraoperative blood loss, operative duration, early postoperaive complications, the presence of an isthmocele 6 months after surgery and residual myometrial thickness were assessed. Results. The lowest rate of isthmocele formation was 9% (n=5) in group 3, where T.Vejnovic technique was used to restore the uterine wall integrity. The myometrium thickness of 7.9 (0.25) mm in the area of postoperative scar after previous cesarean section was significantly larger compared to group 1 5.6 (1.94) mm (p=0,01), and group 2: 4.7(2.37) mm (p=0.005). Conclusion. To preserve the normal thickness of uterine walls during cesarean section, T. Vejnovic modified uterine suture technique proved to be more effective compared to single-row and double-row suturing with no statistically significant differences in reduction in the incidence of isthmocele (niche).

caesarean section, isthmocele, uterine niche, T.Vejnovich technique