[Blunt or sharp expansion of cesarean section: a comparative study].

OBJECTIVE

The aim of this study was to determine if the method used to expand the hysterotomy during a cesarean section (c-section) could affect maternal blood loss and uterine laceration.

MATERIAL AND METHODS

Prospective study including 214 c-sections divided into two groups. Hundred and thirty-six were assigned to have blunt expansion of the uterine incision (group 1) and 78 to have sharp expansion by scissors (group 2). Maternal blood loss, change in hemoglobin level, and uterine tears were studied.

RESULTS

The median blood loss was (IQR) 475mL (300-700) and 500mL (300-800) (P=0.227) in groups 1 and 2 respectively. The decrease in hemoglobin level was 9.5g/L versus 6g/L (P=0.007) in groups 1 and 2. Nine lateral uterine extensions of uterine incision (5.88%) were found in the group 1, three of them were complicated by a wound of the uterine vascular pedicle. One lateral uterine tear with vascular wound was found in the group 2 (1.28%).

CONCLUSION

Sharp expansions were associated with a lower shift in hemoglobin level and a trend to more uterine lacerations.