Developments in caesarean section techniques: a review

Uzoigwe, Samuel A; Jeremiah, Israel

doi:10.4314/njm.v15i1.37111

Cited by 6 publications

(11 citation statements)

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“…Prior to 1876, a series of 22 caesarean deliveries performed in Paris demonstrated a 100% maternal mortality rate, most due to haemorrhage and infection 5 . Porro advocated hysterectomy during a caesarean section to control uterine haemorrhage and prevent infection.…”

Section: Trends After Porromentioning

confidence: 99%

“…He published a monograph in 1882, largerly based on experience of surgeons in the United States who had used internal closing sutures, explaining the principles and technique of caesarean delivery, including aseptic preparation, with special emphasis on a twostep uterine closure using silver wire and silk, and careful attention to hemostasis 5 . The use of silver wire stitches was developed by the 19 th century gynaecologist J. Marion Sims, who invented his sutures to repair vaginal tears that had resulted from traumatic childbirth 5 . Sanger thought that this approach would obviate the growing tendency for caesarean hysterectomy caused by fear of haemorrhage and infection.…”

Section: Trends After Porromentioning

confidence: 99%

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History of caesarean hysterectomy

Sparić¹,

Kadija²,

Hudelist

et al. 2012

ACTA CHIR IUG

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Caesarean hysterectomy evolved as a life-saving procedure following caesarean delivery. The concept underlying caesarean hysterectomy dates back to the mid 1700s and with a description of the procedure performed on laboratory animals. Eduardo Porro of Milan performed the first planned caesarean hysterectomy in which both the infant and the mother survived. He documented his operation in a paper published in 1876. Porro advocated hysterectomy combined with caesarean section to control post partum haemorrhage and to prevent infection. The maternal death rate following the operation remained high, but was substantly below the rate prior to the introduction of the procedure. The Porro procedure contributed to more favourable outcome for both the mother and the infant, having sterility and premature menopause as its side effects. Fortunately, the need for the procedure was soon minimised following the proposal to close the uterine incision with sutures. Although elective caesarean hysterectomy is still a controversial issue, there is no doubt that emergency post partum hysterectomy in case of massive obstetric haemorrhage is potentially life-saving. Over the past decades, the availability of potent uterotonics and broad-spectrum antibiotics, the development of embolisation techniques, and new methods of vessel ligation, have markedly reduced the need for caesarean hysterectomy, which, however, remains an important procedure in modern obstetric practice.

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Section: Trends After Porromentioning

confidence: 99%

Section: Trends After Porromentioning

confidence: 99%

History of caesarean hysterectomy

Sparić¹,

Kadija²,

Hudelist

et al. 2012

ACTA CHIR IUG

View full text Add to dashboard Cite

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“…Caesarean section is one of the oldest operations in medical history with far reaching effect on the modern practice of obstetrics 4 . It was probably performed by traumatic accident or mainly post-mortem for several millennia in the ancient worlds of Mesopotamia, India, Egypt, Isreal and Rome [5][6][7] . The origin of caesarean section is unclear.…”

Section: Introductionmentioning

confidence: 99%

“…It is also believed to have originated from the Roman custom, Lex Cesare in 715BC. The first documented case of successful caesarean section with the survival of the wife and baby was in 1500 by Jacob Nuffer [5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

“…In 1876 Eduardo Porro (1842-1902) controlled haemorrhage and sepsis following caesarean section by performing total hysterectomy and bilateral salpingooophorectomy and suturing cervical stump to the anterior abdominal wall thereby reducing by half the mortality rate from its usual rate of 80-90%. The lower segment uterine incision was popularized by Munro Kerr who performed his first lower segment caesarean section in 1911 and reported his result in the 1920s and 1930s but acceptance by the British congress of Obstetrics and Gynaecology was in 1949 [7][8][9] . Since then the role of caesarean section has been transformed from one carrying terrifying risks to the one which maternal death is extremely rare.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Blunt Versus Sharp Expansion of Uterine Incision on Degree of Intraoperative Blood Loss at Caesarean Section

Nonye-Enyidah¹,

S²

2018

GJMS

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Background:Caesarean section is the most common major operation performed on women. Although caesarean section is much safe today due to improved techniques, anaesthesia, blood transfusion services and antibiotics, there are still major intra operative and post operative complications. Haemorrhage is one of the short term morbidities following caesarean section and may lead to maternal mortality. Aim: To determine which method of expansion of uterine incision at caesarean section (sharp and blunt) is associated with a reduction in blood loss. Method: A prospective randomized study conducted among booked antenatal women admitted in antenatal ward for elective caesarean section at the University of Port Harcourt Teaching Hospital (UPTH) over a period of nine months. The eligible 354 women (177 for each group) were counseled for participation in the study and informed consent obtained. A profoma was prepared for each participant. Blood loss estimation (EBL) was undertaken using both volumetric and gravimetric methods. The data was collected and analyzed using EPI INFO statistical software. Results:The mean age of women in blunt group was 31.6 years and 31.7 years in sharp group. All the women had formal education. The mean parity in blunt group was 1.4 and 1.5 in sharp group. The mean gestational age for both groups was 38.1 (SD 1.0) weeks. The mean EBL during the study period was 594.4 (SD 167.0) mls. The mean EBL for sharp group was 602.3 (SD 176.6) mls and 586.4 (SD 157.3) mls for blunt group. The mean EBL for women in blunt group who had uterine extension was 889.3 (SD 100.3) mls while that of sharp was 944.4 (SD190.9) mls. Conclusion:Caesarean section is a common obstetric operation and needs to be made as safe as possible. Although sharp expansion of the lower segment transverse uterine incision resulted in more blood loss, the difference is not statistically significant. The difference in blood loss following inadvertent extension between the two groups is statistically significant. There was no need for a blood transfusion.

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Cesarean delivery surgical techniques in Africa: A survey study from Ethiopia

Gudu,

Sisay,

Wondafrash

et al. 2023

PLoS ONE

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Objective To describe the surgical techniques of Caesarean delivery (CD) practiced by Ethiopian Obstetricians and Gynecologists. Methods A descriptive survey study was conducted in Ethiopia from March 1, 2021 to April 30, 2021. Members of the Ethiopian Society of Obstetrician and Gynecologists were randomly selected and their Cesarean delivery surgical techniques were explored. Data were analyzed using IBM SPSS statistics 22. Simple descriptive analysis were employed and frequencies and percentage were calculated to present the data. Results A total of 258 obstetricians and Gynecologists practicing in Ethiopia were approached with a response rate of 97.3% (251/258). Double layer closure of uterine incision (98.4%) and subcuticular closure of skin wound (96.4%) are practiced by most of the participants. There was a large difference in practice of blunt versus sharp fascia extension (43.3 vs 55.8%), cephalo-caudad versus lateral uterine incision extension (58 vs.39%), and closure versus non-closure of pelvic and parietal peritoneum (57.4 vs 42.6, and 39.8 versus 60.2%). Conclusions Blunt and sharp fascia extension, cephalo-caudad and lateral uterine incision extension, closure and non-closure of the pelvic and parietal peritoneum are practiced by similar numbers of Ethiopian Obstetricians and Gynecologists. This demonstrates a wide variation exists in the techniques of Cesarean Delivery across Ethiopia.

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Developments in caesarean section techniques: a review

Cited by 6 publications

References 0 publications

History of caesarean hysterectomy

History of caesarean hysterectomy

Influence of Blunt Versus Sharp Expansion of Uterine Incision on Degree of Intraoperative Blood Loss at Caesarean Section

Cesarean delivery surgical techniques in Africa: A survey study from Ethiopia

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