Clarel Antoine, MD, of the NYU Grossman School of Medicine in New York, developed a cesarean closure technique called the endometrium-free uterine closure technique (EFCT), which excludes the endometrium during suturing. This method results in less or no residual scar defect in the uterus compared to standard closure[5]. A study published in the Journal of Ultrasound in Medicine confirms that women with EFCT have better scar healing[5]. In a previous 2019 study in the Journal of Maternal-Fetal & Neonatal Medicine, none of 727 patients treated with EFCT had placenta accreta in the cesarean scar, including those with up to nine repeat cesarean sections[5]. EFCT reduces the risk of abnormal placental implantation, known as placenta accreta, which can cause life-threatening bleeding[5]. In non-pregnant women, a scar defect can lead to irregular bleeding, severe menstrual pain, painful intercourse or infertility[5]. Results show fewer placental abnormalities in subsequent pregnancies and lower maternal morbidity in repeat cesarean sections[5]. The American College of Obstetricians and Gynecologists does not yet recommend any specific method of closing the uterus[5].