Uterine Exteriorization vs. In situ Repair of Cesarean Section: A Comparative Study at a Tertiary Care Hospital

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Background: Exteriorization, a valuable repair of uterus technique during cesarean section, requires removal
of uterus temporarily from the abdominal cavity to repair the incision. The objective of this study was to compare the postoperative symptoms of intra-abdominal to extra-abdominal repair of the uterine incision during
caesarean procedure.
Methods: A quasi experimental study done in the Obstetrics and Gynecology unit of Ziauddin University
Hospital, Kamari and Clifton Campus, Karachi from 1st January 2017 to 30th June 2017. A total of 190 patients
were divided into two groups (95 patients in each). In Group A Uterine incision was closed extra abdominally
and in Group B the closure was done intra-abdominally. The rate of nausea, vomiting, hospital stay, wound
infection, fever, returns of bowel sounds, blood loss, and uterine trauma was measured between the two
groups. Statistical analyses were done by applying independent sample t-test and chi-square tests.
Results: Exteriorization was better option above age 35 years and elective cesarean section(C/S) patients
with less Intensity of pain and hospital stay (3 days) but the results were not statistically significant. Caesarean
Section, hemoglobin both pre and post-operative, blood transfusion, the return of bowel sound after surgery,
surgical site infection and uterine trauma between the two groups showed no significant difference.
Conclusion: The postoperative management of Exteriorization was better compared to intra-abdominal
repair but the results were not significant. Exteriorization is an easy, convenient and valid option without complications and can be used especially in cases where difficulty in visualization of uterine scar and hemostasis
is at stake.

Original Article

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