Effect of expansion technique of uterine incision on maternal blood loss in cesarean section

Abstract

Objective: The purpose of this study was to determine whether the method used to expand the uterine incision (sharp vs. blunt) for cesarean section (CS) affects maternal blood loss.

Method: A prospective study conducted on 200 nulliparous who underwent lower segment transverse CS divided into two groups. One hundred women were assigned to have blunt expansion of the uterine incision by fingers of the surgeon, and 100 women to have sharp expansion using bandage scissors. Finally, a comparison of two groups was made regarding blood loss, change in hematocrit, uterine tears and blood transfusion. P < 0.05 was considered significant.

Results: Maternal blood loss and postoperative hematocrit drop were significantly higher in sharp group (375 ± 95 cm³ in blunt vs. 443 ± 86 in sharp, P = 0.001 and 2.4 ± 2.6 in blunt vs. 4.1 ± 2.6 in sharp, P = 0.001, respectively). There was no significant difference in the extension of uterine incision.

Conclusions: Our findings support that blunt expansion of uterine incision during lower segment cesarean is safer and easier than sharp expansion.