Comparative study between blunt expansion versus sharp expansion of the uterine incision in primiparous woman undergoing low-segment transverse cesarean section

Document Type : Original Article

Authors

1 Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University

2 Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University

Abstract

Background: Several surgical methods have been established to reduce intraoperative blood loss in caesarean section deliveries. One of these still-debated methods is the use of sharp or stubborn methods to extend the uterine incision. Depending on individual experiences, various surgeons have recommended each technique.
Aim of the study: To see if the maternal blood loss as a primary outcome is affected by the technique of uterine incision expansion (sharp versus blunt) for caesarean deliveries, with secondary outcomes including unintended extension of uterine incision, injury of uterine vessels, and postoperative pain.
Patients and methods: 500 women from Obstetrics and Gynecology Department at Military Production Specialized Hospital and Bab ALshaaria Maternal University Hospital participated in this randomized clinical trial. They were split into two groups: (250 for each group); (Group A): uterine incision expansion was done bluntly with fingers, (Group B): uterine incision expansion was done sharply with scissors.
Result: In comparison to the blunt extension group, the sharp extension group experienced a considerable increase in estimated blood loss (p < 0.001). Postoperative pain (VAS) was found to be substantially higher in the sharp extension group than in the blunt extension group (p = 0.026).
Conclusion: When compared to sharp dissection of the uterine incision during lower-segment caesarean delivery, blunt dissection of the uterine incision is associated with a significant reduction in blood loss. The use of blunt dissection resulted in significantly less blood loss when volume estimation was used.

Keywords

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