Comparative Study of Single Layer versus Double Layer Closure of Lower Transverse Uterine Incision at Cesarean Delivery
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 0, Vol 8, Issue 2
Abstract
Objective(s): To assess intraoperative and postoperative outcome following single layer closure of lower transverse uterine incision at cesarean section as compared to double layer closure. Method(s): In this prospective randomized controlled study, 200 women scheduled for lower segment cesarean section through Pfannenstiel or sub umbilical midline incision were randomized to either single layer (n = 100) or double layer (n=100) closure of uterine incision. Primary outcome measures studied were operating time, intraoperative blood loss, febrile morbidity, and endomyometritis. Secondary outcome measures studied were number of additional hemostatic sutures needed, postoperative pain, perioperative hemoglobin fall, cystitis, wound infection, and hospitalization period. Student t test was used for comparing continuous variables. Categorical variables were compared by Chi square test or Fisher exact test. Results: The maternal demographic factors, indications for cesarean sections and high risk factors were similar between the two groups. There was significant reduction in operating time (P=0.022), intraoperative blood loss (P=0.04), febrile morbidity (P=0.024, OR 0.41, 95% CI (0.17-0.95), perioperative hemoglobin fall (P=0.044), endomyometritis (P=0.03, OR 0.36, 95% CI 0.16-0.90, and period of hospitalization (P=0.00005) in the subjects as compared to controls. There was no significant difference between the two groups regarding number of additional hemostatic sutures needed, postoperative pain, and cystitis or wound infection. Conclusion(s): Single layer closure of lower transverse uterine incision at cesarean section is associated with lesser operating time, intraoperative blood loss, febrile morbidity, endomyometritis, and hospitalization period, as compared to double layer closure.
Authors and Affiliations
Manisha M. Laddad , Sanjay Kumar Patil , Nitin S. Skirsagar , Neha Gupta
Keywords
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