Title: Comparative Study between Exteriorization of Uterus during Caesarean Section versus Intra Peritoneal or In-Situ Repair
Authors: Dr Deepali Jain, Dr Mukhram Devanda, Dr Narendra Mahavar, Dr Ajay Sharma, Dr Sandhya Choudhary, Dr Meenakshi Samriya
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.128
Abstract
Introduction
Caesarean delivery defines the birth of a foetus via laparotomy and then hysterotomy. It is the delivery of an infant, alive or dead, through an abdominal uterine incision after period of viability. From 1996 to 2011, the caesarean delivery rate in United States increase from 20% of all deliveries to 33%. In India rate of the caesarean section raised 17.2% in 2015-16 (NFHS-4) in relation to 8.5% in 2005-06 (NFHS-3) data. Cesarean section rate in Rajasthan in 2015-16 was 8.6% as compare to 3.8% in 2005-06 (Source NFHS-3).1
A figure below 5% implies that a substantial proportion of woman do not have access to surgical obstetric care; on the other hand a rate higher than 15 percent indicate over utilization of the procedure for other than life saving reason (WHO;2010). The level of caesarean section is well above the mentioned WHO ratio of 15% for many of the countries, and it is increasing over the time.1
References
1. Anderson ER, Gates S. Techniques and materials for closure of the abdominal wall in caesarean section. Cochran Database Syst Rev. 2004: CD004663.
2. Antonella Cromi Md. PHD et al Blunt expansion of the low transverse uterine incision at caesarean delivery: a randomized comparison of 2 techniques. America Journal of Obstetrics & Gynaecology, Sept 2008; Vol. 199: Pg. 292-294.
3. Bujold E, Bujold C, Hamilton EF, Hanel F, Gauthier RJ. The impact of a single layer or double layer closure on uterine rupture Am J Obstet. Gynecol. 2002; 186: 1326-30.
4. Sood Atul Kumar. Exteriorisation of uterus at caesarean section. J Obstet Gynaecol, July/Aug 2003; Vol. 53. No. 4: pg. 353-358.
5. Coutinho IC, Ronios de Amorin MM, Katz L, Bandeira de Feraz AA. Uterine exteriorisation compared with in situ repair at caesarean delivery: a randomized controlled trial. Jr of Obstet Gynecol. 2008 Jul; 112(1): 183.
6. Ezechi OC, Kalu BK, Njokanma FO, Mwokoro CA, Okeke GC, Uterine incision closure at caesarean section : a randomised comparative study of intra peritoneal closure and closure after temporary exteriorisation. West Afr J Med, 2005 Jan-March, 24(1): 41-3.
7. MA Wahab, P Karantzis. A randomized controlled study of uterine exteriorisation and repair at caesarean section. British Journal Obstetrics and Gynaecology, 1999; Vol. 106, Issue 9, pg 913-916.
8. Edi Osagie EC, Hopkins RE, Ogdo V et al Uterine exteriorisation at caesarean section infiuence on maternal morbidity. Br J Obstet Gynaecol. 1998; 105: 1070-1078.
9. Orji Fo, Olaleye AO, Loto OM, Ogunniyn SO. A randomized controlled trial of Uterine exteriorisation and non-exteriorisation at caesarean section. Aust NZJ Obstet Gynaecol, 2008 Dec; 48(6): 570-4.
10. Colin A Walsh, Stewart R Walsh. Extraabdominal v/s intraabdominal uterine repair at caesarean delivery: a meta analysis. American Journal of Obstetrics and Gynaecology, June 2009; 200(6): 625e1-625e8.
11. Mughina Siddiqui MD et al. Complications of Exteriorisation versus insitu uterine repair at caesarean section Canadian Journal of Anaesthesia, 2004: 52(139): 730-1000.
12. Nafisi S. Influence of uterine exteriorisation versus insitu repair on post caesarean maternal pain: a randomized trial. Int J Obstet Anesth. 2007 April. 16 (2): 135-8.
13. JC Carvalho. Siddiqui M, Goldszmidt E, Fallah S. Complications of exteriorisation compared with in situ uterine repair at caesarean delivery under spinal anaesth-esia: a randomised controlled trial. Obstet. Gynaecol, 2007 Sept; 110(3):570-5.
14. Ozbay K et al. Exteriorized versus in-situ repair of the uterine incision at caesarean delivery: a randomized controlled trial. Clin Exp Obstet Gynecol. 2011;38(2):155-8.
15. Dr. K.K. Das et al. Comparative Study between Exteriorization of Uterus during Caesarean Section versus Intraperitoneal or in-Situ Repair. Sch. J. App. Med. Sci., October 2015; 3(7D):2724-2728.
16. Hershey DW, Quilligan EJ Uterine exteriorisation at caesarean section. Obstet Gynaecol. 1978; 52: 189-92.
17. Xiong Quing et al: Uterine repair with exteriorisation or insitu at caesarean section: A randomized controlled trial. Chinese Journal of Evidence Based Medicine, 2004; 09-25, pg 615-619.
Dr Deepali Jain
Senior Professor, Department of Obstetrics & Gynaecology,
J.L.N Medical College, Ajmer, Rajasthan