LAUSR

Dear Editor, Reference is made to the article published in your esteemed journal titled “Babu and Magon uterine closure technique during cesarean section: A randomized double-bind trial” Tahermanesh et al. doi:10.1111/jog. 14889. I felt humbled and honored for getting our technique of uterine closure chosen for a randomized controlled trial (RCT) and that has emerged as a technique that assures better myometrial healing. I congratulate the authors for a well-conducted study. In this article, the primary outcome studied was the defect in the scar (small niche and the large niche). This aspect affects the residual myometrial thickness which is the surrogate marker of better myometrial wound healing. However, it has been observed that the figure shown in the article as the final appearance of Babu and Magon technique is incorrect. It could possibly due to an incorrectly drawn figure or an incorrectly performed technique. If it is the latter case, it is to be emphasized that an incorrect surgical technique has a great adverse impact on the final outcome of the scar. A correctly performed technique (Figure 1a,b: Diagrammatic representation of the sutures with Babu and Magon technique) will have the appearance of the scar as shown in Figure 2a,b. Appearance of uterine scar with Babu and Magon technique following Caesarean and myomectomy). A randomized control study by Roberge et al. assessed the impact of residual myometrial thickness (RMT) following cesarean section by three different techniques; single layer locked, double layer locked, and double layer unlocked. The best RMT achieved in this study was with double layer unlocked technique (6.09 2.21 mm). Although Babu and Magon technique (modified mattress suture) was not included in this study, I would like to share our unpublished data of residual myometrial thickness (9.55 1.47 mm) studied in 27 cases. In addition, there was no small or large niche in any of the cases.