الفهرس 
Title : Effect Of Blunt Extension Of Myometrial Incision Versus Sharp Extension During Cesarean Section On Isthmocele Development
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Abstract
Background:Cesarean section is one of the most common surgical procedures in the world .its complications results in maternal morbidity and mortality. Cesarean scar niche is one of these complications that deserves studying.
Objectives:To assess whether sharp extension of uterus in cesarean section is better or the blunt one regarding scar niche formation.
Methods:In this clinical trial 280 pregnant women who undergone their first cesarean section with regional anathesia were randomized into two groups according to uterine incision. Sharp incision and blunt incision. The assessment of presence of scar niche was done after six weeks postpartum with transvaginal ultrasound and again further assessment by transvaginal ultrasound at three months postpartum.
Results: significant differences noted in operative time and blood loss during incision closure which were larger in sharp incision while uterine vessel injuries were larger in blunt group ,non significant differences noted in incision extension but blunt incision resulted in less number of incision extensions .Regarding post-operative follow up ,non significant differences noted as sharp incision resulted in less number of niche by transvaginal ultrasound 6 weeks and 3 months postpartum. Sharp incision also resulted in larger adjacent myometrial thickness.
Conclusion:There was no difference between sharp and blunt extension of uterine incision regarding formation of cesarean scar niche and scar thickness. Sharp incision might be better than blunt one as it cause well coaptedmyometrial layers.