Comparison of uterine closure techniques during caesarean section on isthmocele formation-A Randomized controlled trial

Caesarean section is increasing worldwide. Current caesarean section rate is 15-20%. As a result of caesarean section, there are chances for suture site weakening. Medical terminology for weakness of scar, resulting in bulge in lower uterus is called as isthmocele or niche. Isthmocele results in menstrual abnormality in inter-delivery period. During pregnancy, it can result in scar thinning out during delivery. Usually uterine closure  is done with  either  single layer or double layer closure technique, single layer uterine closure technique results in slightly higher chance of  weakening of scar compared to double layer. Within double layer closure there are different techniques. We aim to compare 3 different  double  layered suturing methods  [ double layer  locking versus double layer unlocking versus Babu and Magon technique (Far Far Near Near technique)] and check technique results in thick scar without isthmocele formation. Following 6-12 months of caesarean section, we perform a vaginal scan to check the whether the scar is healed well or there is formation of isthmocele. In this way of research, we are trying to find out the effective  method of suturing technique to reduce chances of  rupture uterus in next  pregnancy.