Single- versus Double-Layer Uterine Closure and Cesarean Scar Outcomes at Defined Postpartum Intervals: A Time-Stratified Meta-Analysis of Randomized Trials

The authors aimed to compare the effects of single-layer versus double-layer uterine closure after cesarean delivery on subsequent cesarean scar outcomes, particularly focusing on uterine rupture or dehiscence in future pregnancies. Their meta-analysis of 21 randomized controlled trials found no significant differences in the primary outcome or niche incidence between the two techniques, although double-layer closure was associated with thicker residual myometrial thickness and single-layer closure with shallower niche depth at certain follow-up intervals. The findings highlight the need for further research to assess the long-term clinical implications of these sonographic markers.