Niche development after closure of caesarean uterotomy by conventional double‐suture or modified single‐suture technique (NICUM): A randomized trial

Abstract Introduction The aim of the study was to compare two different techniques for closure caesarean uterotomy on occurrence a scar niche. Methods randomized controlled trial performed in tertiary hospital with inclusion singleton pregnant women scheduled, first section. We participants techniques; (1) Conventional double‐suture using running suture involving myometrium followed by superficial or (2) modified single‐suture technique alternating deep‐superficial stitches. primary outcome proportion niches >2 mm deep at 6 months' follow‐up transvaginal hysterosalinography. Secondary outcomes included residual myometrial thickness and niche measurements. Analyses were intention‐to‐treat. Results 230 women; 115 each intervention group. rate >70% both groups. Caesarean occurred 42/81 (52%) after versus 35/81 (43%) (risk difference [RD] 8.6% (95% confidence interval [CI] −6.9; 24.2)). Women group had more additional stitches closure. deeper than (RD 0.52 CI 0.01–1.02). There no other differences ultrasonograpic maternal clinical secondary between Conclusion hypothesized decreased as compared but did not observe techniques.