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Uterine Scar Resection During Repeat Cesarean Delivery to Prevent Uterine Niche Formation

NCT07228858 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 170

Last updated 2025-12-29

No results posted yet for this study

Summary

The purpose of the study is to evaluate whether resection of the previous cesarean scar at repeat cesarean delivery reduces uterine niche formation and related morbidity without increasing operative risks.

Conditions

  • Cesarean Section Complications
  • Scar Niche
  • Scarred Uterus

Interventions

PROCEDURE

Repeated cesarean section with previous uterine cesarean section scar resection

After creating the bladder flap, the uterus was incised 5 mm cranial to the scar and extended laterally 5 mm beyond its ends. After delivery of the newborn, a 1 cm segment of uterine wall (5 mm above and 5 mm below the scar) was excised. The incision edges were approximated with a central vertical mattress suture, followed by double-layer continuous myometrial closure including decidua with visceral peritoneum closure.

PROCEDURE

Repeated cesarean section without uterine scar resection

Standard repeat cesarean section without scar resection, followed by double-layer continuous myometrial closure including decidua with visceral peritoneum closure.

DIAGNOSTIC_TEST

Saline-infusion Sonohysterography

At 6 months postpartum, all participants are to be evaluated by a single blinded sonographer experienced in niche assessment. First, transvaginal ultrasound was performed to exclude pregnancy or pelvic pathology, followed by saline-infusion sonohysterography (2D, sagittal and coronal views). A niche is defined as ≥ 2 mm myometrial indentation at the scar site. Niche depth, length, width, and residual myometrial thickness are to be recorded.

Sponsors & Collaborators

  • Benha University

    lead OTHER

Principal Investigators

  • AHMED ALNEZAMY, MD · Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Benha University

Study Design

Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
45 Years
Sex
FEMALE
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-02-09
Primary Completion
2025-05-30
Completion
2025-11-30

Countries

  • Egypt

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07228858 on ClinicalTrials.gov