Evaluation of postoperative outcome of different techniques of lower segment caesarean section
Keywords:Caesarean, Misgav Ladach, Pfannensteil Kerr
Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.
Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.
Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav technique.
Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.
Bamigboye AA, Hofmeyr GJ. Non-closure of peritoneal surfaces at caesarean section--a systematic review. S Afr Med J. 2005;95(2):123-6.
Arias F, Bhide AG, Arulkumaran S, Damania K, Daftary SN, editors. Practical guide to high risk pregnancy and delivery. Elsevier Health Sci. 2012.
Grivell RM, Dodd JM. Short-and long-term outcomes after Caesarean section. Expert Rev Obstet Gynecol. 2011;6(2):205-15.
Deshpande H, Burute SB, Madkar CS, Dahiya P. The effect of suturing and nonsuturing of visceral and parietal peritoneum on postoperative pain in caesarean section. Int J Pharm Biomed Sci. 2012;3(4):164-6.
Mocanasu C, Anton E, Chirila R. Peritoneal suture vs. non-suture at caesarean section. Rev Med Chir Soc Med Nat Iasi. 2005;109(4):810-2.
Vitale SG, Marilli I, Cignini P, Padula F, D’Emidio L, Mangiafico L et al. Comparison between modified Misgav-Ladach and Pfannensteil-Kerr techniques for Caesarean section: review of literature. J Prenatal Med. 2014;8(3-4):36.
National Institute for Health and Clinical Excellence. CG132 Caesarean Section. Available at: http://guidance.nice.org.uk/CG132
Abalos E, Addo V, Brocklehurst P, El MS, Farrell B, Gray S, Hardy P, Juszczak E, Mathews JE, Masood SN, Oyarzun E. Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial. Lancet. 2013;382(9888):234-48.
Enkin MW, Wilkinson C. Single versus two layer suturing for closing the uterine incision at caesarean section. The Cochrane database of systematic reviews. 2000(2):CD000192.
Gencdal N, Gencdal S, Ekmekci E. Comparison of Pfannensteil Kerr and Modified Misgav Ladach Methods of Caeserean Operation. Women’s Health Gynecol. 2016;2(3):1-5.
11. WHO. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva: World Health Organization;2017. Available at https://www.who.int/nutrition/.../guidelines/breastfeeding-facilities-maternity-newborn.
Sharma A, Hooja N, Shastri A, Nawal R, Bhargava S, Kala M.,Kumawat B,Manish R. Postoperative outcome of caesarean section in closure versus nonclosure of parietal peritoneum. J South Asian Feder Obstet Gynecol. 2018;10(3):182-5.
Cheema HK, Singh C, Mehta SS, Suri S. Closure versus Non-closure of peritoneum in Caesarean section and evaluation of post-operative pain: A hospital-based study. Int J Sci Study. 2014;2(9):89-92.
Agarwal N, Agarwal BK. Effect of Non-Closure of Peritoneum on Outcome of Caesarean Section‾A Prospective Randomized Control Study Int J Sci Res. 2015;4(6).
Moradan S, Mirmohammadkhani M. Comparison of Misgav-Ladach and Pfannenstiel-Kerr Techniques for Cesarean Section: A Randomized Controlled Trial Study. Middle East Journal of Rehabilitation and Health. 2016;3(4).
Hudić I, Bujold E, Fatušić Z, Skokić F, Latifagić A, Kapidžić M, Fatušić J. The Misgav-Ladach method of Caesarean section: a step forward in operative technique in obstetrics. Arch Gynecol Obstet. 2012;286(5):1141-6.
Şahin N, Genc M, Turan GA, Kasap E, Güçlü S. A comparison of 2 Caesarean section methods, modified Misgav-Ladach and Pfannensteil-Kerr: A randomized controlled study. Advances in clinical and experimental medicine: official organ Wroclaw Medical University. 2018.
Nankali A, Farajzadeh F, Rezaei M, Malekkhosravi S, Daeichin S. Comparison of the Outcomes of Traditional and Mis-gav-Ladach Techniques in Caesarean Section. J Biol Today's World. 2014;3(2):44-8.
Adama O, Barnabé YR, Gueswendé KF, Sibraogo K, Paul KD, Alexi SY. Prognosis of Misgav-Ladach Caesarean Sections in an African Environment: Case of the Banfora Regional Hospital in Burkina Faso about 110 Cases. Open J Obstet Gynecol. 2017;7(09):1006.
Tabasi Z, Mahdian M, Abedzadeh-Kalahroudi M. Closure or non–closure of peritoneum in Caesarean section:outcomes of shortterm complications.Arch Trauma Res. 2013:1(4):176-9.
Noreen S, Alam M, Khan WY, Sultana R, Gul S. A comparison of peritoneal closure with non-closure for short term morbidity in emergency lower segment Caesarean section KJMS. 2015;8(1):76-9.
Jindal M, Gupta M, Goraya SP, Matreja PS. Single Layer Versus Double Layer Closure of Uterus during Caesarean Section-A Prospective Study in Index and Subsequent Pregnancy. Int Arch BioMed Clinic Res. 2017;3(1):50-3.