Effect of Non-Dissection of the Inferior Rectus Sheath on Intraoperative Blood Loss

University Hospitals (UH)

Status

Terminated

Conditions

Postoperative Pain

Acute Blood Loss Anemia

Pregnancy

Treatments

Procedure: control

Procedure: non-dissection of inferior rectus sheath

Study type

Interventional

Funder types

Other

Identifiers

NCT02762773

UHCASEMC2

Details and patient eligibility

About

The purpose of this study is to evaluate the effect of non-dissecting the inferior rectus sheath during primary cesarean delivery on post-operative hemoglobin and post-operative pain control as measured by VAS score and opioid anesthesia use in the first 72 hours post-op.

Enrollment

81 patients

Sex

Female

Ages

18+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

- Patients must be 18 years or older as well as willing and able to provide informed consent
Patients undergoing a scheduled or non-scheduled, non-urgent or non-scheduled urgent (delivery within 30 minutes of decision for surgical delivery) Cesarean delivery between >35 weeks gestational age,
Patients who are expected to receive a Pfannenstiel incision
Patients with viable singleton intra-uterine pregnancy
Patients with fetus in cephalic presentation

Exclusion criteria

- Patients younger than 18 years,
Patients unable or unwilling to provide informed consent,
Patients who are illiterate,
Patients who are non-English speaking or reading,
Patients who are medical or nursing students at a school affiliated with University Hospital
Multi-fetal gestations (>1 intrauterine pregnancy),
Patients with a BMI >50 kg/m^2
Patients with a suspected placenta accreta or placenta previa
patients with 2 prior cesarean deliveries
Patient undergoing emergent cesarean delivery (delivery within 10 minutes of decision for surgical delivery)
Patients who will require a vertical skin incision, Maylard or Cherney incisions
Patients with a history of significant pelvic adhesive disease, as determined by prior operative reports
Patients with fetus in non-cephalic presentation
Patients with pre-gestational or gestational diabetes mellitus
Patients with estimated fetal weight >5000 grams
Patients with estimated fetal weight <10% for gestational age
Patients with who require general anesthetic
Patients who are on chronic pain medication
Patients with a history of drug abuse