Optimization of the Healing Process of the Uterine Scar Tissue After Re-cesarean Section

NCT ID: NCT02703519

Last Updated: 2016-09-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

116 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-11-30

Study Completion Date

2016-08-31

Brief Summary

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This prospective, controlled, clinical, intervention study measures the number of uterine Cesarean section scars and median myometrial thickness of women who underwent two Cesarean sections six to nine months after their last Cesarean section using transvaginal ultrasound.

It is the purpose of the study to assess if a resection of the uterine scar from a previous Cesarean section during a second Cesarean section could lead to a decrease in risk for subsequent pregnancies.

Detailed Description

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The average number of Cesarean sections in Germany has doubled from 1991 to 2011, making up 32,1% of all deliveries in 2011.

Several studies describe instances in which pregnancies following a previous Cesarean section were accompanied by complications such as life-threatening bleeding, placenta previa, placenta accreta, increta or percreta and dehiscence or uterine rupture.

The risk of those complications increases further with the uterine scar tissue of a second Cesarean section.

Today it is already common practice to resect uterine scars if the scar of a previous Cesarean section becomes symptomatic, or when a non-symptomatic uterine rupture or serious dehiscence are discovered during a Cesarean delivery.

In this study all participants of the interventional group are examined via intraoperative ultrasound to identify the first uterine Cesarean section scar and resect it completely.

Six to nine months after the resection participants will return for a one time follow-up. At this time, the investigators will measure the number of uterine scars and median myometrial thickness using transvaginal ultrasound. The results will be compared with those of two control groups, consisting of women who underwent either one or two Cesarean sections without the intervention.

The aim of the present study is to asses if the number of uterine scars and median myometrial thickness can be improved by the resection of the first uterine scar during a subsequent Cesarean section.

This will allow the investigators to draw conclusions regarding the benefit of routine resections of uterine Cesarean section scars, and whether this practice could lead to a decreased risk for women undergoing two or more Cesarean sections.

Conditions

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Scar; Previous Cesarean Section Complications; Cesarean Section, Wound, Dehiscence

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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1 cesarean section

control group

Group Type NO_INTERVENTION

No interventions assigned to this group

2 cesarean sections

control group

Group Type NO_INTERVENTION

No interventions assigned to this group

resection of uterine scar tissue

2 cesarean sections with resection of uterine scar tissue from first cesarean section

Group Type EXPERIMENTAL

resection of uterine scar tissue

Intervention Type PROCEDURE

resection of uterine scar tissue of a previous cesarean section during a second cesarean section

Interventions

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resection of uterine scar tissue

resection of uterine scar tissue of a previous cesarean section during a second cesarean section

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* 18 years or older
* primary or secondary indication for cesarean section 6 to 9 months prior to the examination date

Exclusion Criteria

* \<18 years old
* current pregnancy
* congenital deformity of the uterus
* former surgery of the uterine myometrium
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Otto-von-Guericke University Magdeburg

OTHER

Sponsor Role collaborator

Martin-Luther-Universität Halle-Wittenberg

OTHER

Sponsor Role lead

Responsible Party

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Gregor Seliger

Dr. med., chief resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gregor Seliger, Dr. med.

Role: PRINCIPAL_INVESTIGATOR

Maternity Clinic/Perinatal Treatment Center, Halle University Hospital, Martin-Luther-Universität Halle-Wittenberg

Michael Tchirikov, Prof.

Role: STUDY_CHAIR

Maternity Clinic/Perinatal Treatment Center, Halle University Hospital, Martin-Luther-Universität Halle-Wittenberg

Serben-Dan Costa, Prof.

Role: PRINCIPAL_INVESTIGATOR

Maternity Clinic, Magdeburg University Hospital

Locations

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Maternity Clinic/Perinatal Treatment Center, Halle University Hospital, Martin-Luther-Universität Halle-Wittenberg

Halle, Saxony-Anhalt, Germany

Site Status

Maternity Clinic, Magdeburg University Hospital

Magdeburg, Saxony-Anhalt, Germany

Site Status

Countries

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Germany

Other Identifiers

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OPSTAR

Identifier Type: -

Identifier Source: org_study_id

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