Is cephalad-caudad blunt expansion of the low transverse uterine incision really associated with less uncontrolled extensions to decrease intra-operative blood loss? A prospective randomised-controlled trial. (17th June 2016)

• Record Type: Journal Article
• Authors: Ozcan, Pinar; Ates, Seda; Guner Can, Meltem; Sarioglu Yardımcı, Asli; Batmaz, Gonca; Kilic, Gokhan
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 12(2016)
• Page Start: 1952
• Page End: 1956
• Publication Date: 2016-06-17
• Subjects: Caesarean section -- cephalad-caudad blunt expansion -- obstetric haemorrhage -- uterine incision; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2015.1069813
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To determine which type of blunt expansion of a low transverse uterine incision during operative delivery is associated with decreased blood loss and intra- and post-operative morbidity for a caesarean section (CS). Methods : The prospective randomised-controlled trial was conducted at the Department of Obstetrics and Gynecology, Bezmialem University Hospital. The patients were randomly assigned to a group that received a cephalad-caudad ( n = 55) or transverse ( n = 57) blunt expansion of the low transverse uterine incision. Intra- and post-operative morbidity at caesarean delivery in short-term including blood loss, operating time, post-operative pain with the faces pain rating scale, and post-operative morbidity were analysed. Results : The changes in both haemoglobin ( p < 0.01) and haematocrit ( p < 0.01) from the pre-operative to post-operative values, estimates of blood loss ( p < 0.01) were significantly lower in cephalad-caudad group and the post-operative haematocrit concentrations ( p = 0.02) were significantly greater in cephalad-caudad group when compared with the transverse group. The damage of parametrial and uterine vessels into lateral edges were recorded in 11 (19.6%) patients in transverse group and 7 (12.9%) patients in cephalad-caudad group and there is no statistical significance between groups in terms of these parameters ( p > 0.05, 95% CI 0.19, 1.63). Conclusion : Our findings suggest that cephalad-caudad blunt expansion of the low transverse uterine incision decreases blood loss compared to transverse blunt dissection.