Comparison of intraoperative hemorrhage by blunt versus sharp expansion of uterine incision at caesarean delivery
Noreen Tahir, Shazia Amir Khan, Rakhshanda Aslam, Naila Bangash.
Objective: In order to reduce blood loss during surgery while performing lower segment transverse cesarean section, two techniques of expansion of uterine incision (sharp versus blunt) and their effect upon intra-operative blood loss were studied.
Methodology: A randomized controlled trial was conducted at District Headquarter Teaching Hospital, Rawalpindi, Pakistan from July 15, 2016 to December 15, 2016. All women with term pregnancy who required primary lower segment cesarean section were taken in two groups. The study included 140 women; 70 had their uterine incision expanded by sharp method and 70 had it by the blunt method. Standard surgical techniques were used in both the groups. Demographic characteristics and clinical data were recorded. Two groups were compared regarding change in hematocrit after surgery.
Results: No significant difference was found between the two groups regarding their demographic characteristics and clinical data including age, parity, type and stage of labor and pre-operative hematocrit. There was a significant drop in post-operative hematocrit in the patients in whom a blunt expansion of uterine incision was made (p=0.00).
Conclusion: Sharp expansion of uterine incision during lower segment cesarean section was associated with lesser blood loss.
Caesarean section, surgical techniques, uterine incision.
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Approved by the Higher Education Commission of Pakistan and Pakistan Medical and Dental Council