Journal of Rafsanjan University of Medical Sciences

Background and Objective: Cesarean section is performed so frequently that even modest differences in outcome that result from a better technique can have effects on cost and public health. The purpose of this study was to compare two methods (transverse and cephalad) of expansion of the low transverse uterine incision in cesarean section.

Materials and Methods: In this randomized clinical controlled trial in 145 women who had low segment transverse cesarean section, the initial uterine incision was extended transversally and in 143 women in a cephalad- cauded direction. Outcomes of this study included unintended extension of uterine incision, uterine vessel injury, need for additional sutures after closure of uterine incision, blood transfusion, estimation of intraoperative blood loss, and decreased Hb value more than 10 percent after operation. Data were evaluated using t-test, chi-square test, and Fisher's exact test.

Results: No significant difference was found between the two groups regarding patient characteristics, indication of surgery, and type of anesthesia and proportion of emergency procedures. The occurrence of uterine vessel injury (5.51% versus 2/09%, P=0.010), need for additional sutures for controlling uterine incision bleeding (17.93% versus 2.79%, P<0.001), and intraoperative estimated blood loss (689 versus 579 mL, P= 0.001) were significantly higher in the transverse group than in the cephalad- cauded group.

Conclusion: probably the cephalad- cauded technique is preferred when low segment transverse cesarean section is performed.

Key words: Cesarean section, Hystrotomy, Uterine incision, Lower segment, Surgical technique, Outcome assessment

Funding: This study did not have funds.

Conflict of interest: None declared.

Ethical approval: The Ethics Committee of Zahedan University of Medical Sciences approved the study.

How to cite this article: Mokhtari M, Yaghmaei M, Mohammadi M, Mirzaei E. Comparison of some outcomes of two techniques for expansion of the low transverse uterine incision at cesarean section. J Rafsanjan Univ Med Sci 2017; 16(2): 217-26. [Farsi]