Comparison of Purse String Suture vs Transverse Mattress Suture to Maintain Hemostasis in Thinned-out Caesarean Sections Scars

NCT07758959 | Active Not Recruiting

• 2 other identifiers: lahore general hospitalirb no 199/24
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Brief Summary The goal of this clinical trial is to compare the effectiveness of purse-string suture versus transverse mattress suture for achieving hemostasis in women with thinned-out lower uterine segment scars undergoing repeat cesarean section. The study aims to determine whether the purse-string suture technique provides faster and more effective hemostasis than the transverse mattress suture technique. The main questions it aims to answer are:

• Does the purse-string suture reduce the time required to achieve hemostasis compared with the transverse mattress suture?
• Does the purse-string suture reduce the number of additional sutures required to achieve adequate hemostasis? Researchers will compare purse-string suturing with transverse mattress suturing to determine which technique achieves hemostasis more efficiently in women with thinned-out cesarean section scars. Participants will:
• Undergo repeat cesarean section under standard surgical care.
• Be randomly assigned to receive either purse-string suturing or transverse mattress suturing for repair of the thinned-out lower uterine segment after closure of the first uterine layer.
• Have the time required to achieve hemostasis and the number of sutures required recorded intraoperatively.
• Receive routine postoperative management according to institutional protocols. Suggested improvement Although the thesis mentions only time to achieve hemostasis and number of sutures as outcomes, ClinicalTrials.gov prefers that the primary outcome be clearly identified. Since your sample size was calculated using time to achieve hemostasis, I recommend presenting it as:
• Primary outcome: Time to achieve hemostasis (minutes)
• Secondary outcomes: Number of sutures required for hemostasis; duration of cesarean section (minutes)

Conditions

Thinned-out Lower Uterine Segment Scar Previous Cesarean Section

Keywords

Cesarean Section; Repeat Cesarean Section

Outcome Measures

Primary Outcomes (2)

• Time to Achieve Hemostasis

  Time (in minutes) required to achieve complete hemostasis of the thinned-out lower uterine segment following application of the assigned suturing technique during repeat cesarean section.

  During the surgical procedure (intraoperative)

• Time to Achieve Hemostasis

  Time (in minutes) required to achieve complete hemostasis of the thinned-out lower uterine segment following application of the assigned suturing technique during repeat cesarean section.

  Intraoperative (during cesarean section)

Secondary Outcomes (1)

• Number of Sutures Required to Achieve Hemostasis

  Intraoperative (during cesarean section)

Study Arms (2)

Arm 1 Arm Title: Purse-String Suture

EXPERIMENTAL

Participants undergoing repeat cesarean section with a thinned-out lower uterine segment scar underwent uterine repair using the purse-string suture technique to achieve hemostasis.

Procedure: Purse-String Suture

Arm 2 Arm Title: Transverse Mattress Suture

EXPERIMENTAL

Participants undergoing repeat cesarean section with a thinned-out lower uterine segment scar underwent uterine repair using the transverse mattress suture technique to achieve hemostasis.

Procedure: Transverse Mattress Suture

Interventions

Purse-String Suture PROCEDURE

Purse-string suturing of the thinned-out lower uterine segment during repeat cesarean section.

Arm 1 Arm Title: Purse-String Suture

Transverse Mattress Suture PROCEDURE

Transverse mattress suturing of the thinned-out lower uterine segment during repeat cesarean section.

Arm 2 Arm Title: Transverse Mattress Suture

Eligibility Criteria

• Age: 18 Years - 40 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Females aged 18 to 40 years.
• Gestational age \>37 weeks at the time of delivery.
• Parity \<5.
• History of one or more previous cesarean sections.
• Intraoperative evidence of a thinned-out lower uterine segment scar during repeat cesarean section.

You may not qualify if:

• Preeclampsia (blood pressure ≥140/90 mmHg with proteinuria \>+1 on dipstick).
• Gestational diabetes mellitus.
• Placental abnormalities, including placenta previa, placenta accreta spectrum (accreta/increta), or placental abruption.
• Previous uterine repair scar.
• Coagulation disorder (prothrombin time \>15 seconds).

Sponsors & Collaborators

• Natasha Bushra: lead
• Lahore General Hospital: collaborator

Study Sites (1)

Lahore general hospital

Lahore, Punjab Province, 54070, Pakistan

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor obstetrics and gynaecology

Study Record Dates

• First Submitted: August 6, 2026
• First Posted: August 11, 2026
• Study Start: August 6, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: August 11, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)