Uterine exteriorization versus intraperitoneal repair in primary and repeat cesarean delivery: a randomized controlled trial. (1st February 2022)

• Record Type: Journal Article
• Authors: Mohr-Sasson, Aya; Castel, Elias; Lurie, Irina; Heifetz, Sigal; Kees, Salim; Sivan, Eyal
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 3(2022)
• Page Start: 433
• Page End: 438
• Publication Date: 2022-02-01
• Subjects: Intraperitoneal repair -- primary cesarean delivery -- repeat cesarean delivery -- uterine exteriorization -- uterine insicition; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2020.1720638
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Purpose: The aim of this study is to evaluate the effect of uterine exteriorization versus intraperitoneal repair, in first compared to repeat cesarean delivery. Methods: A prospective randomized control single-blinded trial conducted in a single tertiary center between March 2014 and March 2015, including 32 and 63 women in first and recurrent cesarean sections, respectively. Inclusion criteria were elective operation and gestational age ≥37 weeks. Operative outcomes were compared between the groups including mean operative time, blood loss, hypotension, perioperative nausea and pain. Post-operative outcomes were further compared, including post-operative analgesia demand, first recognized bowel movement, nausea, length of hospital stay, fever, endometritis surgical site infection rate, and total satisfaction. Results: During the study period, 45 and 50 women were designated for uterine exteriorization and intraperitoneal uterine repair, respectively. Mean blood loss was 452 cc (±10.44) for the extraperitoneal compared to 540 cc (±29.83) for the intraperitoneal uterine repair group ( p = .004). No other significant differences in either intraoperative or postoperative complications were demonstrated in and between the groups. Conclusion: Intraperitoneal repair of uterine incision is associated with higher operative blood loss compared to uterine exteriorization. No other differences in operative and postoperative complication rates were found between the groups.