Abstract
Objectives:To compare the effect of blunt and sharp incision of uterus at cesarean section on intra-operative haemorrhage.Methods:This trial was conducted at the Department of Obstetrics and Gynaecology, Pakistan Ordinance Factory Hospital, Wah Cantt from 14th January to 13th July 2012. Total 80 women planned for lower segment cesarean section through Pfannensteil incision were randomized to either blunt uterine incision (Group-A, n=40) or sharp uterine incision (Group-B, n=40). The fall in Haemoglobin and HCT was compared in two groups and analyzed with help of SPSS version 10.Results:Both groups were similar in terms of demographic features like age, parity, gestational age and indication for cesarean section. The participants in Group-A reveled significantly less drop of mean Hb concentration as compared to Group-B (1.47±1.08 and 1.95±0.85 respectively, P value 0.031). Similarly, the fall in mean HCT was significantly less in Group-A in comparison to Group-B (3.21±1.3 and 4.21±2.17 respectively, P-value 0.015)Conclusion:Blunt expansion of uterine incision during caesarean section is associated with less fall in Haemoglobin and HCT as compared to sharp expansion.
Highlights
Cesarean delivery is an operating procedure used to deliver babies that is indicated to avoid maternal and neonatal mortality
The mean fall in haemocrit and Hb was statistically significant in the participants of Group-B as compared to Group-A
Several surgical techniques have been developed over passage of time like vertical and transverse incision in uterine wall but the most popular is the transverse uterine incision and is used commonly by obstetricians.[10,11]
Summary
Cesarean delivery is an operating procedure used to deliver babies that is indicated to avoid maternal and neonatal mortality. It is associated with short- and long-term hazards. CS rates have increased, and efforts are being made to ensure that CS is performed only when essential.[1] Rates of cesarean delivery have augmented by about 7.0% to 31% in recent years.[2] Varieties of surgical techniques are there to adopt, but very little data is available about proper technique to inform and to adopt. As the rates of postoperative morbidity due to cesarean delivery are higher in developing countries, improvements in health from proper cesarean delivery technique are likely to be significant in these countries.[3]
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