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Using this method, it is shown that multiple closures with very short dwell times, which may occur before a sustained closure, can occur in circumstances where the geometric model predicts a single closure with a significant time span.
She warned that a single closure at short notice could result in a woman in advanced labour being told to travel miles to another hospital, "leaving them anxious and frightened about having their baby in a car or by the roadside".
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When they shut most of 183-mile network of the "Muddle & Get Nowhere" in 1959, it was the biggest single railway closure yet seen in Britain and since then the railway has acquired an almost mythical status – hard to appreciate unless you can understand that curious cocktail of nostalgia, sentiment and overwhelming sense of loss that fuels railway enthusiasm.
The main finding was an increased risk of uterine rupture with previous single layer closure.
Thus women who had single layer closure may have been more likely to have a trial of labour.
In contrast to our study of a single school closure event in response to 1 seasonal outbreak, the French study considered preplanned holiday periods spanning many years.
This study's result was not replicated by a second observational study, which found no increased risk of uterine rupture with single layer closure [ 21].
The observational study by Bujold et al has raised the possibility of an increased risk of uterine rupture in labour after single layer closure, and further research using larger, randomised controlled studies is needed to investigate this possible association.
There was no association between single-layer closure and other pelvic or abdominal adhesions.Primary single-layer hysterotomy closure may be associated with more frequent bladder adhesions during repeat caesarean deliveries.
For example, for women randomised in a hospital which is taking part in the three comparisons: sharp vs blunt abdominal entry; double vs single layer uterine closure; and closure vs non-closure of the peritoneum; then it will be at the discretion of the surgeon as to whether there is exteriorisation of the uterus or not, and what suture material is used for uterine repair.
Single-layer closure of the uterus at cesarean delivery has been associated with an increased risk of uterine rupture compared with double-layer closure.
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