Objective: Cesarean scar defects (CSD) are a problem that may lead to complications and excessive cost. The optimal way to suture the uterus is a matter of debate. The aim of this study was to evaluate the effect of two suture materials on cesarean scar niches. 

Study Design: This was a cohort study that allocated women into two groups:  uterotomy closure with vicryl or catgut sutures. Transvaginal ultrasound (TVUS) was performed six months after the cesarean section (CS) to assess the scar. 

Results: Totally, 250 patients enrolled in this study. After six months, 20 (18.2%) patients in the catgut suture group and 13 (9.3%) patients in the vicryl group had isthmocele according to their sonography reports. The prevalence of isthmocele was higher in the catgut group (p=0.03). The residual myometrial thickness was greater in the vicryl group (4.98cm ± 2.18) compared to the catgut suture group (3.70cm ± 1.50; p = 0.001). The prevalence of postoperative gynecological sequelae such as postmenstrual spotting and pain were similar between the two groups. 

Conclusion: Vicryl sutures were associated with a lower risk of CSD formation in comparison with catgut sutures.

To be updated