Cesarean Section Complications
Conditions
Keywords
vertical splitting, Cesarean Section Complications, uterine vessels, injury
Brief summary
Cesarean section is one of the oldest surgical interventions in the history of medicine.Many variations in cesarean section technique have been studied.The investigatory team are aiming to decrease blood loss during cesarean section by vertical splitting versus transverse cutting of muscle layer in lower segment cesarean sections to avoid uterine vessels injury.
Detailed description
Cesarean section is one of the oldest surgical interventions in the history of medicine.Since the first documented cesarean delivery in 1020 AD, various modifications have been made in the technique. It was a surgery performed as a last resort, mostly peri- or post-portem. Many variations in cesarean section technique have been studied.our study aim is to decrease blood loss during cesarean section through decreasing incidence of uterine vessels injury. The investigator supposed that applying Vertical pull on a small C-shaped incision in the lower uterine segment during cesarean section allows the tissues to split along their natural arrangement, decreasing the probability of extension of the wound into the uterine vessels, thus; decreasing blood loss; operative time and maternal recovery.
Interventions
PROCEDURETransverse cutting
Transverse cutting and/or pulling.of lower uterine segment during lower cesarean section extending the uterine incision laterally.
PROCEDUREvertical splitting
vertical splitting of lower uterine segment during lower cesarean section making the direction of traction up and downward instead of being laterally and we suppose that this will allow the tissues to split along their natural arrangement, decreasing the probability of extension of the wound into the uterine vessels, thus; decreasing blood loss; operative time and maternal recovery.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
* Elective cesarean section * No medical disorders during pregnancy ( Hypertension, DM , ..) * No coagulation disorders either congenital nor acquired.
Exclusion criteria
* Urgent or emergency cesarean section. * Multiple pregnancy. * Presence of medical disorders during pregnancy ( Hypertension, DM , ..) * Presence of coagulation disorders either congenital nor acquired.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Uterine vessels injury | 1 minute after extraction of the baby and placenta | the surgeon performing the cesarean section will detect if injury of uterine vessels occurred or not while extending uterine incision. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| uterine incision extension | 2 minutes extraction of the baby and placenta | the surgeon performing the cesarean section will detect if uterine incision extension occurred or not after extraction of the baby and the placenta. |
| intra-operative blood loss | before closure of the abdominal wall layer | blood loss will be assessed by circulating nurse through counting soaked surgical towels and gauze and calculating estimated blood loss in vacation suction system. |
| postpartum hemorrhage | first 24 hours after delivery | will be defined by postpartum blood loss of 1000cc |
| postoperative pain | 2 hours after delivery | pain scale from 0 to 10 to assess postoperative pain after delivery |
Countries
Egypt
Outcome results
None listed