Trial reportInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2025
Determinants of residual myometrial thickness after cesarean delivery: Comparative analysis of barbed versus conventional sutures-A sub-analysis from the SPIRAL trial.
Trial report in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Determinants of residual myometrial thickness after cesarean delivery: Comparative analysis of barbed versus conventional sutures-A sub-analysis from the SPIRAL trial.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Trial
- 'The good idea': a commentary on a decade of barbed sutures in cesarean surgery.Annals of medicine · 2026Review
- Reproductive and clinical outcomes after minimally invasive isthmocele repair: a comparison of robotic-assisted and laparoscopic approaches.Archives of gynecology and obstetrics · 2026Article
- Barbed Double-Needle Suture for Cesarean Section Uterine Incision Closure: Postoperative Pain and 12-Month Scar Outcomes.Journal of pain research · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis sub-analysis aimed to determine whether conventional suture-associated risk factors for cesarean scar defect show similar outcomes with barbed continuous suturing, and to identify factors influencing residual myometrial thickness when using barbed continuous sutures.
methodsThis sub-analysis of a multicenter, parallel-group, randomized controlled trial across four Japanese obstetrics and gynecology departments included 1211 women who had their first cesarean delivery between May 2020 and March 2023. Among them, 298 women underwent a C-section, with 253 follow-up through July 2023. Singleton pregnancies were randomly assigned to receive either barbed or conventional double-layered continuous sutures in a 1:1 ratio; they were monitored from consent through their 6- to 7-month check-up. The effects of cervical ripening, facility characteristics, and surgeon experience were investigated using a two-way ANOVA.
resultsOf the remaining 253 patients, 33 were lost to follow-up and 220 completed follow-up (110 per group). One institution enrolled the largest proportion of participants (45.9%), whereas two other institutions had more experienced surgeons. Two-way ANOVA revealed that surgeon experience (P = 0.020) and institutional factors (P < 0.001) significantly influenced the residual myometrial thickness at 6-7 months after surgery, whereas cervical dilation during active labor did not (P = 0.215). Additionally, a significant interaction was observed between institutional factors and suture type (barbed vs. conventional) on residual myometrial thickness (P
conclusionInstitutional factors and surgeon experience represent significant determinants of residual myometrial thickness when using barbed sutures for cesarean closure, highlighting the importance of standardized surgical protocols and training across facilities.
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