Uterine incision closure at caesarean section: A randomised comparative study of intraperitoneal closure and closure after temporary exteriorisation

Uterine exteriorization compared with in situ repair for Cesarean delivery: a systematic review and meta-analysis

“…With the exception of three of the 16 included studies, 11,24,31 blood loss was reported by either a reduction in hemoglobin or estimated blood loss, although the method of estimating blood loss varied greatly between studies. It should be emphasized that, in all but one study 32 reporting estimated blood loss, the difference in blood loss between groups was less than 100 mL. This minimal clinical impact is shown by the lack of a difference in blood transfusions between repair groups.…”

“…Pooled results from ten studies (17,568 patients) 9,[11][12][13][27][28][29][30][31][32] did not show a significant difference between groups for blood transfusion (OR, 1.07; 95% CI, 0.48 to 2.41; I 2 = 51%) ( Table 3, Fig. 2A).…”

“…Pooled results for estimated blood loss from six studies (908 patients) 7,9,[26][27][28]32 showed no statistically significant difference between the two repair techniques (MD, -61.03 mL; 95% CI, -127.34 to 5.28; I 2 = 76%) ( Table 3, Table 2 The Cochrane Collaboration tool for assessing risk of bias 16 ElKhayat 2C). Visual inspection of the forest plot revealed a potential outlier study 28 in which the authors had divided the study population into four groups, further differentiating between manual and spontaneous removal of the placenta.…”

“…Many studies reported postoperative pain outcomes (including pain at six hours, 13,31 ten hours, 8 24 hr, 29,31 34 hr, 8 or 36 hr 31 postoperatively), the number of analgesic doses, 9,31,32 the need for postoperative rescue analgesics, 8,[11][12][13]31 and opioid consumption. 10 A detailed summary of these results for postoperative pain outcome is presented in Table 4.…”

Comparative Study between Exteriorization of Uterus during Caesarean Section versus Intra Peritoneal or In-Situ Repair

“…Thus the 2 groups are comparable with respect to indications of caesarean section. In the study by Sood Atul Kumar et al 4 6 found significant difference in the estimated blood loss which was less in exteriorised group (P = 0.009) and postoperative anaemia rate were significant less in exteriorised group (P = 0.028). MA Wahad, P Karantzis et al 7 from their study stated that exteriorisation of uterus had a statistically significant association with reduced blood loss (P < 0.05).…”