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Cephalad-caudad versus transverse blunt expansion of the low transverse uterine incision during cesarean delivery

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dc.contributor.authorXodo, Serena
dc.contributor.authorSaccone, Gabriele
dc.contributor.authorCromi, Antonella
dc.contributor.authorÖZCAN, Pınar
dc.contributor.authorSpagnolo, Emanuela
dc.contributor.authorBerghella, Vincenzo
dc.contributor.institutionauthorÖZCAN, PINAR
dc.date.accessioned2020-10-22T15:56:31Z
dc.date.available2020-10-22T15:56:31Z
dc.date.issued2016-07-01T00:00:00Z
dc.description.abstractIt is imperative to have evidence-based guidelines for cesarean delivery. The aim of this meta-analysis was to evaluate the effectiveness of a cephalad caudad compared to transverse blunt expansion of the uterine incision to reduce blood loss in women who underwent low-segment transverse cesarean delivery. We therefore performed a systematic search in electronic databases from their inception until March 2016. We included all randomized trials comparing cephalad caudad versus transverse (control group) blunt expansion of the uterine incision in women who underwent a low transverse cesarean delivery. The primary outcome was postpartum blood loss, defined as the mean amount of blood loss (mL). Two trials (921 women) were analyzed. After the transverse uterine incision in the lower uterine segment with the scalpel, the uterine incision was then bluntly expanded by the designated method. Blunt expansion of the primary incision was derived by placing the index fingers of the operating surgeon into the incision and pulling the fingers apart laterally (transverse group) or cephalad (cephalad caudad group). Women who were randomized in the cephalad caudad group had lower: mean of postpartum blood loss, hemoglobin drop and hematocrit drop 24 h after cesarean, unintended extension, uterine vessels injury, blood loss >1500 mL and need for additional stitches. There was no statistically significant difference in the incidence of blood loss >1000 mL, in the operating time and in post-operative pain. In conclusion, expansion of the uterine incision with fingers in a cephalad caudad direction is associated with better maternal outcomes and, therefore, should be preferred to transverse expansion during a cesarean delivery. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
dc.identifier.citationXodo S., Saccone G., Cromi A., ÖZCAN P., Spagnolo E., Berghella V., -Cephalad-caudad versus transverse blunt expansion of the low transverse uterine incision during cesarean delivery-, EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, cilt.202, ss.75-80, 2016
dc.identifier.doi10.1016/j.ejogrb.2016.04.035
dc.identifier.pubmed27180273
dc.identifier.scopus84966351773
dc.identifier.urihttp://hdl.handle.net/20.500.12645/23698
dc.identifier.wosWOS:000379095300015
dc.titleCephalad-caudad versus transverse blunt expansion of the low transverse uterine incision during cesarean delivery
dc.typeArticle
dspace.entity.typePublication
local.avesis.id50c086e3-2fcb-4543-922a-bbfcf1912756
local.publication.goal03 - Sağlık ve Kaliteli Yaşam
local.publication.isinternational1
relation.isAuthorOfPublicationa223be34-acbb-4ec3-8217-209ec916f373
relation.isAuthorOfPublication.latestForDiscoverya223be34-acbb-4ec3-8217-209ec916f373
relation.isGoalOfPublication9c198c48-b603-4e2f-8366-04edcfc1224c
relation.isGoalOfPublication.latestForDiscovery9c198c48-b603-4e2f-8366-04edcfc1224c
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