Peritoneal non-closure at caesarean section

Abstract

Background: It has been suggested that the peritoneal suture might be omitted during caesarean section without adverse effects.

Objectives: The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intra-operative and immediate postoperative outcomes.

Search strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register.

Selection criteria: Controlled trials comparing leaving the visceral and/or parietal peritoneum unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section.

Data collection and analysis: Trial quality was assessed and data were extracted by two reviewers.

Main results: Four trials involving 1194 women were included. Non-closure of the peritoneum saved operating time (weighted mean difference of -6.12 minutes, 95% confidence interval -8.00 to -4.27) with no significant differences in postoperative morbidity, analgesic requirements and length of hospital stay. There was a consistent, although nonsignificant, trend for improved immediate postoperative outcome if the peritoneum was not closed.

Reviewer's conclusions: There seems to be no significant difference in short term morbidity from non-closure of the peritoneum at caesarean section.