Blunt versus sharp expansion of uterine incision during lower segment cesarean section.

BACKGROUND

The method of uterine incision expansion throughout lower segment cesarean section (LSCS) may impact intraoperative blood loss and surgical outcomes. This research aims to compare the effects of blunt versus sharp expansion of the uterine incision on intraoperative hemorrhage by assessing changes in hematocrit (HCT) levels. Secondary outcomes include the incidence of uterine artery injury, the need for intraoperative blood transfusion, and the duration of the cesarean section procedure.

METHODS

Comparative prospective research was performed at Ain Shams University Maternity Hospital. A total of 120 pregnant women meeting inclusion criteria were randomly assigned into two groups: Group A (blunt expansion using fingers) and Group B (sharp expansion using scissors). Preoperative and postoperative HCT levels were measured to assess intraoperative blood loss. Additional parameters were recorded and analyzed utilizing SPSS software. A p-value < 0.05 was considered significant.

RESULTS

The blunt expansion group demonstrated significantly lower intraoperative blood loss, as indicated by a smaller decline in HCT levels (mean difference: 0.9%) compared to the sharp expansion group. Hemoglobin and red blood cell count also showed significantly better preservation in the blunt method group. There was insignificant variance among the two groups regarding uterine artery injury incidence, the need for blood transfusion, or the duration of the cesarean section procedure.

CONCLUSION

Blunt expansion of the uterine incision during LSCS was related to reduced intraoperative blood loss. The findings suggested that blunt expansion may be the preferable technique in cesarean deliveries to minimize blood loss while maintaining surgical efficiency.