Nonclosure of the peritoneum during caesarean section: long-term follow-up of a randomised controlled trial

Abstract

Objective: To compare long-term morbidity of nonclosure and closure of the peritoneum at caesarean section.

Study design: Participants to a randomised controlled trial were contacted 7 years later. Outcome measures were assessed by a postal questionnaire and reports of subsequent operations.

Results: We were able to contact 226 of the 280 women recruited initially, and 144 responded to the questionnaire. Sixty-nine had been allocated to nonclosure of the peritoneum and 75 to closure. Baseline characteristics at randomisation were comparable both between the respondents and the non-respondents, and between originally allocated groups. No statistically significant difference was found between the two groups regarding fertility, abdominal pain, and urinary symptoms. Among 29 reports of subsequent abdominal surgery, 14 mentioned the presence of adhesions (8 in the nonclosure and 6 in the closure group; P=0.47). The number of women reporting at least one significant morbidity was similar between groups (24 in the nonclosure and 19 in the closure group; P=0.72).

Conclusion: Nonclosure and closure of the peritoneum at caesarean section result in similar long-term morbidity.