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A randomized controlled trial of uterine exteriorization versus in situ repair of the uterine incision during cesarean delivery
Author(s) -
ElKhayat Waleed,
Elsharkawi Mohamed,
Hassan Amr
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.05.004
Subject(s) - medicine , cesarean delivery , surgery , randomized controlled trial , abdominal surgery , anesthesia , pregnancy , genetics , biology
Objective To compare extra‐abdominal repair of the uterine incision at cesarean delivery with in situ repair. Methods The present study was a double‐blind randomized controlled trial conducted at a university hospital in Egypt during 2012–2013, and included women with an indication for cesarean delivery. Extra‐abdominal repair was used in group 1 (n = 500) and in situ repair in group 2 (n = 500). The primary outcome measure was the surgery duration. Results Surgery duration was significantly longer in group 1 than group 2 (49.9 ± 2.3 minutes vs 39.9 ± 1.8 minutes; P < 0.001). More patients in group 1 than in group 2 had postoperative moderate‐to‐severe pain (165 [33.0%] vs 115 [23.0%]; P = 0.001) and needed additional postoperative analgesia (100 [20.0%] vs 50 [10.0%]; P < 0.001). Moreover, mean time to bowel movement was longer in group 1 than in group 2 (17.0 ± 2.7 hours vs 14.0 ± 1.9 hours; P < 0.001). Conclusion In situ uterine closure is more advantageous than extra‐abdominal repair in terms of surgery duration, postoperative pain and need for additional analgesia, and return of bowel movement. ClinicalTrials.gov : NCT01723605