Complications of blunt versus sharp expansion of the uterine
incision in lower segment caesarean section – a randomized
controlled trial
Jayasundara D.M.C.Sa, Rajapakse R.N.Gb.
a Consultant Obstetrician and Gynaecologist, District General Hospital, Mullaithiu, Sri Lanka.
b Consultant Obstetrician and Gynaecologist, North Colombo Teaching Hospital, Ragama, Sri Lanka
Results
Abstract
Methods
Caesarean section is a common obstetric
surgical procedure. This was a
randomised controlled trial involving 274
women at a tertiary care centre in Sri
Lanka done to compare the
complications of blunt versus sharp
expansion of uterine incision at
caesarean section. Here the sharp
expansion method was found to be
superior to blunt expansion method
Objectives
•
To compare the incidence of
complications associated with blunt
versus sharp expansion of the uterine
incision at the time of caesarean
section,
• the percentage of inadvertent
extensions,
• percentage drop in Haematocrit
• to assess how this changed with
cervical dilatation.
274 women who underwent a lower
segment caesarean section at North
Colombo Teaching Hospital, Ragama, Sri
Lanka was assigned randomly to have
the expansion of the primary uterine
incision either bluntly using the index
fingers of both hands of the surgeon or
sharply using a curved scissors. Rest of
the surgery was performed alike in all
participants
Results
Conclusion
Sharp expansion is associated with lower
complication rate and is preferable to blunt
expansion method during caesarean
section.
Its more advantages at elective section and
when the cervical dilation is less than 4cm.
References
1.
Blunt versus sharp expansion of the uterine
incision in low segment transverse
caesarean section. Am J Obstet Gynecol
1994