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: non-dissection of inferior rectus sheath

Procedure: control

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