Abstract:
OBJECTIVE: To compare the two methods of closure of uterine incision i.E an additional single figure of eight stitch at the centre of uterine incision after a double layered closure versus the standard double layered closure during caesarean section in terms of intra operative haemorrhage, post operative blood loss, use of oxytocics and additional haemostatic sutures STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: The obstetrics and Gynaecology Department of Combined Military Hospital Rawalpindi from March 2005 to March 2006. MATERIALS AND METHODS: A total of 130 selected pregnant women between 37 and 42 weeks of gestation were admitted and randomly divided into two groups i.E the standard double layered closure (group-I)and the modified uterine stitch (group-II). Caesarean section was performed according to the standard procedures except uterine closure.In group-I, standard double layered closure was performed and in group-II, an additional figure of eight stitch at the centre of uterine incision was applied and outcomes like operation time, intra operative haemorrhage, post operative blood loss, need for oxytocics, additional haemostatic sutures and agents, difference in pre and post operative haemoglobin levels, febrile morbidity and length of hospitalization were recorded. Statistical analysis was done using SPSS V 14. RESULTS: There was a significant difference in pre and post operative blood loss (mean 1,035.83 ml vs 694.00 ml; p 0.002 and mean 398.34 ml vs 282.88 ml; p 0.005) as well as difference in haemoglobin levels (mean 1.46 G/dl vs 1.01 G/dl; p 0.008) in the Group-I and Group-II respectively; use of oxytocics and additional haemostatic sutures in favour of the modified uterine stitch Group. There was no significant difference in febrile morbidity (p 0.89) and length of hospitalization (p 0.686) between the two groups. CONCLUSION: This uterine stitch is associated with less intra and post operative haemorrhage as well as less need for additional haemostatic sutures and agents.
Page(s):
148-152
DOI:
DOI not available
Published:
Journal: Isra Medical Journal, Volume: 4, Issue: 3, Year: 2012