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
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