Portal de Periódicos da CAPES

Techniques for cesarean section

2009; Elsevier BV; Volume: 201; Issue: 5 Linguagem: Inglês

10.1016/j.ajog.2009.03.018

1097-6868

Justus G. Hofmeyr, Natalia Novikova, Matthews Mathai, Archana Shah,

Anesthesia and Pain Management

The effects of complete methods of cesarean section (CS) were compared. Metaanalysis of randomized controlled trials of intention to perform CS using different techniques was carried out. Joel-Cohen–based CS compared with Pfannenstiel CS was associated with reduced blood loss, operating time, time to oral intake, fever, duration of postoperative pain, analgesic injections, and time from skin incision to birth of the baby. Misgav-Ladach compared with the traditional method was associated with reduced blood loss, operating time, time to mobilization, and length of postoperative stay for the mother. Joel-Cohen–based methods have advantages compared with Pfannenstiel and traditional (lower midline) CS techniques. However, these trials do not provide information on serious and long-term outcomes. The effects of complete methods of cesarean section (CS) were compared. Metaanalysis of randomized controlled trials of intention to perform CS using different techniques was carried out. Joel-Cohen–based CS compared with Pfannenstiel CS was associated with reduced blood loss, operating time, time to oral intake, fever, duration of postoperative pain, analgesic injections, and time from skin incision to birth of the baby. Misgav-Ladach compared with the traditional method was associated with reduced blood loss, operating time, time to mobilization, and length of postoperative stay for the mother. Joel-Cohen–based methods have advantages compared with Pfannenstiel and traditional (lower midline) CS techniques. However, these trials do not provide information on serious and long-term outcomes. The fifteen minute cesarean deliveryAmerican Journal of Obstetrics & GynecologyVol. 203Issue 2PreviewHofmeyr et al1 wrote a very interesting comparison of the various techniques for performing a cesarean delivery. However, I was struck by the operating times, which, with 1 exception,2 range from 27.5 to 56.5 minutes. The one exception (the Misgav Ladach technique) involves a good deal of finger dissection, which I find awkward, and only a single-layer uterine closure. It is possible to do a cesarean delivery in 15 minutes without rushing and to include a double-layer uterine closure and a subcuticular skin closure. Full-Text PDF