Exteriorization Versus Non-exteriorization of the Uterus During Repair of Uterine Incision in a Repeated Cesarean Section
- Conditions
- Intrapartum Hemorrhage
- Interventions
- Procedure: Repair of uterine incisionProcedure: Exteriorization of the uterusProcedure: Non exteriorization of the uterus
- Registration Number
- NCT03009994
- Lead Sponsor
- Assiut University
- Brief Summary
Cesarean section is one of the most frequently performed major operations worldwide. It accounts for between 1% and 70% of deliveries depending on the facilities or country assessed. In Egypt, the cesarean section rate is 22%, with higher rates seen in private hospitals. In 2015 ,incidence of cesarean section rate in Woman Health Hospital in Assiut university is 51.3% of all deliveries.
Different Operational techniques For cesarean section have been defined aimed at reducing surgical time, making the surgery easier and more efficient, lowering costs,decreasing the risk of adverse effects and postoperative morbidity, as well as length of hospital stay.
Also, Intraoperative blood loss is one of important complications during cesarean section. A systematic review included twenty one studies, in 2011, revealed that increase incidence of intraoperative blood loss and blood transfusion with increase number of cesarean deliveries.also anemia in the pregnancy increase maternal morbidities included intraoperative blood loss. In Egypt, prevalence of Iron deficiency anemia among pregnant women about 51% of pregnant women.
After baby born by cesarean section and the placenta has been extracted, uterine incision is sutured either by temporary removal of the uterus from the abdominal cavity (exteriorization of the uterus) to facilitate uterine incision repair or it is repaired within the abdominal cavity (in situ repair). There had been few randomized controlled trials comparing intraoperative and postoperative morbidity following exteriorization of the uterus with non-exteriorization. The conclusions drawn from these trials have been conflicting.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 1024
- Pregnant women in 28 weeks
- Women who will undergo repeated lower segment cesarean section
- First cesarean section
- Placenta previa.
- Rupture uterus.
- Classical caesarean section.(upper segment cesarean section)
- Sever Preeclampsia.
- Chorioamnionitis.
- prolonged or obstructed labour.
- Fibroid.
- Polyhydramnios.
- Multiple pregnancy.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Exteriorization group Repair of uterine incision After delivery of the fetus and placenta, the surgeon bring uterus yet out from peritoneal cavity by manual handling of the uterus uterus from fundus and extracted out of the abdominal cavity before starting to close it. After repair of the uterus , uterus returned to abdominal cavity and repair anterior abdominal wall as following. Exteriorization group Exteriorization of the uterus After delivery of the fetus and placenta, the surgeon bring uterus yet out from peritoneal cavity by manual handling of the uterus uterus from fundus and extracted out of the abdominal cavity before starting to close it. After repair of the uterus , uterus returned to abdominal cavity and repair anterior abdominal wall as following. Non exteriorization group Repair of uterine incision Uterine incision will be repaired intra abdominally Non exteriorization group Non exteriorization of the uterus Uterine incision will be repaired intra abdominally
- Primary Outcome Measures
Name Time Method Postoperative Hemoglobin (gm/L) 20 minutes Intraoperative blood loss (mL) 20 minutes
- Secondary Outcome Measures
Name Time Method Duration of operation (minutes) 20 minutes
Trial Locations
- Locations (1)
Assiut university
🇪🇬Assiut, Egypt