Evidence-based surgical procedures to optimize caesarean outcomes: an overview of systematic reviews

Gialdini, Celina; Chamillard, Monica; Diaz, Virginia; Pasquale, Julia; Thangaratinam, Shakila; Abalos, Edgardo; Torloni, Maria Regina; Betran, Ana Pilar

doi:10.1016/j.eclinm.2024.102632

eClinicalMedicine

2024

DOI: 10.1016/j.eclinm.2024.102632

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Evidence-based surgical procedures to optimize caesarean outcomes: an overview of systematic reviews

Celina Gialdini,

Monica Chamillard,

Virginia Diaz

et al.

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2024

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Cited by 2 publications

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Cesarean section: One procedure, varied techniques. Detailed observations of 1013 first cesarean sections in a tertiary hospital in Ghana

Asah‐Opoku,

Heesterman,

Zeevaert

et al. 2024

Intl J Gynecology & Obste

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ObjectiveCesarean sections (CS) are among the most performed surgical procedures in the world. Small variations in surgical techniques could have a significant impact on a global scale, for example, in postoperative complications. In the present study we aimed to observe and audit every single step used during first time CS.MethodsDescriptive cross‐sectional study from January 1, 2018 to January 14, 2020 at a tertiary hospital in Ghana. Techniques used for CS were directly observed and thoroughly documented. Standard descriptive methods were used for data analysis.ResultsOf the 1013 first time CS, 81.4% were emergency procedures. The mean (SD) gestational age at CS was 38.4 ± 3 weeks. Low transverse incision was used in 993/1013 (98%) of cases. Blunt dissection of subcuticular tissue was done in 48/1013 (4.7%), blunt separation of rectus fascia in 386/1013 (38.1%), blunt opening of peritoneum in 838/1013 (82.7%) and lower uterine segment incision with scalpel in 995/1013 (98.2%) women. A total of 916/1013 (90.4%) had double layered uterine closure, 961/1013 (94.9%) had uterus exteriorized for repair, 382/1013 (37.7%) had closure of the peritoneum, 655/1013 (64.7%) had non‐closure of the rectus muscle, 677/1013 (66.8%) had subcutaneous tissue closed and 983/1013 (97.0%) had skin closed with subcuticular stitches. There were 493 different combinations of techniques observed performed by 85 surgeons for carrying out a complete first time CS.ConclusionThere is a wide variety of methods used for first time CS. There is the need for training and retraining on the techniques for CS using evidence‐based guidelines.

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Cesarean section: One procedure, varied techniques. Detailed observations of 1013 first cesarean sections in a tertiary hospital in Ghana

Asah‐Opoku,

Heesterman,

Zeevaert

et al. 2024

Intl J Gynecology & Obste

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Enhancing Postoperative Analgesia After Cesarean Section: Insights Into Transversus Abdominis Plane Block, Intrathecal Opioids, and Other Analgesic Techniques

El-Tallawy,

Pergolizzi,

Amlih

et al. 2024

Cureus

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Evidence-based surgical procedures to optimize caesarean outcomes: an overview of systematic reviews

Cited by 2 publications

References 66 publications

Cesarean section: One procedure, varied techniques. Detailed observations of 1013 first cesarean sections in a tertiary hospital in Ghana

Cesarean section: One procedure, varied techniques. Detailed observations of 1013 first cesarean sections in a tertiary hospital in Ghana

Enhancing Postoperative Analgesia After Cesarean Section: Insights Into Transversus Abdominis Plane Block, Intrathecal Opioids, and Other Analgesic Techniques

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