The purpose of this clinical trial is to compare the incidence of defects in the uterine wall at the site of the scar (niche) and surgical complications when using high-segment versus low-segment hysterotomy, with both cross-suturing and non-cross-suturing techniques, in pregnant patients undergoing their first cesarean section.
Researchers will compare four arms:
* Low Segment Hysterotomy + Crossed hysterorrhaphy * High Segment Hysterotomy + Crossed hysterorrhaphy * Low Segment Hysterotomy + Non-Crossed hysterorrhaphy * High Segment Hysterotomy + Non-Crossed hysterorrhaphy
Participants will:
* Cesarean delivery * Attend a follow up appointment between 6 to 16 weeks post surgery where will be perform a transvaginal sonography.
Pregnant women aged ≥ 18 years.
Confirmed pregnancy through clinical history or ultrasound between 36 and 42 weeks of gestation.
Indication by the attending gynecologist for a first cesarean section, either emergent or elective.
History of myometrial intervention, such as myomectomy.
History of genetic or acquired conditions that alter the anatomy of the uterus.
History of coagulation disorders.
History of connective tissue disorders, such as Lupus and Scleroderma, which may affect healing.