Maternal outcome of caesarean section with or without eventration of the uterus: a prospective observational study

Background: Caesarean section is a commonest surgical procedure performed by an obstetrician. Many variations in technique of caesarean section have been devised with the intent of shortening the operating time, making the operation easier, safer and more efficient; and to decrease the blood loss, postoperative morbidity, other complications as well as to shorten the period of hospitalization. One such variation is in the technique of repair of the uterus, whether it is repaired in situ or taken out from the incision and repaired outside the abdomen before replacing it back in place. This study was designed to compare two techniques of uterine closure and determine the benefit of using one technique over the other.Methods: A prospective observational study on 100 women who underwent caesarean section. Technique of uterine repair was surgeon dependent and was not influenced by investigator. Based on this, patients were assigned into two separate groups (exteriorised group and in situ repair group). Observation was made and recorded regarding the various preoperative, intraoperative parameters and the surgeon`s technique of uterine closure. The patients were then followed up and various postoperative outcome variables were recorded.Results: There were no statistically significant differences between the two groups with regards to any of the intraoperative or postoperative parameters except that there was a rise in diastolic pressure in exteriorization group during eventration which gradually came down during the suturing and reposition (P < 0.05).Conclusions: With this study, it can be concluded that clinical outcomes remain unaffected by any of the two methods of uterine repair. Both are equally safe. However, a caution must be exercised in intraoperative blood pressure monitoring, especially when the uterus is being exteriorized for repair as there is a statistically significant rise in diastolic blood pressure during eventration