Effect of Expansion Technique of Uterine Incision at Caesarean Delivery on the Degree of Intraoperative Blood Loss

The most common major operation performed on women is a Caesarean section. Despite the fact that caesarean sections are now much safer thanks to improved procedures, anaesthesia, blood transfusion facilities, and antibiotics, significant intraoperative and postoperative complications still exist. Haemorrhage is one of the most common short-term complications after a caesarean section, and it may result in maternal death.

The aim of this study was to see which form of uterine incision expansion (sharp or blunt) is associated with less blood loss during caesarean section.

Over a nine-month period, a prospective randomised study was conducted among booked antenatal women admitted to the antenatal ward at the University of Port Harcourt Teaching Hospital (UPTH) for elective caesarean section. The 354 women who were qualified for the study (177 in each group) were counselled and informed consent was obtained. Each participant had a profoma prepared for them. Both volumetric and gravimetric approaches were used to estimate blood loss (EBL). EPI INFO statistical software was used to collect and analyse the data.

The average age of the women in the blunt group was 31.6 years, while the average age of the women in the sharp group was 31.7 years. The women had all received formal schooling. In the blunt group, the mean parity was 1.4, while in the sharp group, it was 1.5. Both groups had a gestational age of 38.1 weeks (SD 1.0). During the study period, the average EBL was 594.4 (SD 167.0) mls. The mean EBL for the sharp group was 602.3 (SD 176.6) mls, while the blunt group had 586.4 (SD 157.3) mls. The mean EBL for women with uterine extension in the blunt group was 889.3 (SD 100.3) mls, while it was 944.4 (SD190.9) mls in the sharp group.

Conclusion: Caesarean sections are a standard obstetric procedure that should be as healthy as possible. While there was more blood loss when the lower segment transverse uterine incision was sharply expanded, the difference was not statistically important. The difference in blood loss between the two groups after inadvertent extension is statistically important. A blood transfusion was not needed.

Author (s) Details

Dr. E. I. Nonye-Enyidah
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt,
Nigeria.

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