Evidence map›Paper›PMID 40833607›Full record

SynthesisArchives of gynecology and obstetrics2025

Single-versus double-layer uterine closure at the time of cesarean delivery and risk of uterine scar niche: a systematic review and meta-analysis of randomized trials.

Mattia Dominoni, Marco Torella, Rossella Molitierno, Mario Fordellone, Gabriele Saccone, Dario Colacurci, Antonio Simone Laganà, Martina Rita Pano, Barbara Gardella, Marco La Verde

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07686913 (A Randomized Prospective Trial Comparing Steri-Strip Application Versus Standard Wound Closure for Cesarean Section Incisions), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07686913 narecruitingnot on this mapstarted 2026, after this paper: background citation

A Randomized Prospective Trial Comparing Steri-Strip Application Versus Standard Wound Closure for Cesarean Section Incisions

TypeinterventionalSponsorRiverside University Health System Medical CenterRan2026 to 2027Enrolled610ConditionsCesarean Section, Surgical Site Infection, Wound Dehiscence, SeromaArmsSteri-Strip™ Skin Closures, Standard Cesarean Wound Closure
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mattia DominoniDepartment of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Corso Strada Nuova, 65, 27100, Pavia, Italy.
Marco TorellaDepartment of Woman, Child and General and Specialized Surgery, Obstetrics and Gynaecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
Rossella MolitiernoDepartment of Woman, Child and General and Specialized Surgery, Obstetrics and Gynaecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
Mario FordelloneMedical Statistics Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
Gabriele SacconeDepartment of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Dario ColacurciDepartment of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy.
Antonio Simone LaganàUnit of Obstetrics and Gynecology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), "Paolo Giaccone" Hospital, University of Palermo, 90127, Palermo, Italy.
Martina Rita PanoDepartment of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Corso Strada Nuova, 65, 27100, Pavia, Italy. martinarita.pano01@universitadipavia.it.
Barbara GardellaDepartment of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Corso Strada Nuova, 65, 27100, Pavia, Italy.
Marco La VerdeDepartment of Woman, Child and General and Specialized Surgery, Obstetrics and Gynaecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review and meta-analysis compared single- versus double-layer uterine closure at the time of cesarean delivery. DATA SOURCES: MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials were searched from inception until May 2024. STUDY ELIGIBILITY CRITERIA: We included only randomized controlled trials (RTSs) that compared single-layer versus double-layer uterine closure at the time of cesarean delivery. STUDY APPRAISAL AND SYNTHESIS

methodsOutcomes were analyzed using a random-effects model. Results are expressed as risk differences. The assessment of the risk of bias was performed by using the Risk of Bias 2 tool. The primary outcome was the incidence of scar defects (i.e., niche) at 6 months after delivery. The secondary outcomes were incidence of scar defects at 6 weeks and 3 months.

resultsA total of 18 studies were identified by the systematic review; 11 RCTs involving 6,058 participants were included in the meta-analysis. There is no statistical difference between single-layer and double-layer uterine closure of cesarean delivery incision regarding the incidence of uterine scar defect at six weeks. Single-layer closure showed a significantly lower incidence of niche after three months (RD = - 0.02 (- 0.06, 0.02); I

conclusionsSingle-layer uterine closure at the time of cesarean delivery resulted in a lower uterine scar defects after three and six months compared to double-layer uterine closure. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, Unique identifier: CRD42024552495.

Indexed as

Cesarean SectionCicatrixPostoperative ComplicationsUterusFemaleHumansPregnancyRandomized Controlled Trials as TopicCesareanCesarean sectionDouble-layerIsthmoceleNicheScar defectsSingle-layerUltrasoundUterine closureUterine scar defect

Identifiers

PMID40833607
PMCPMC12414086

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.