Vertical Splitting of Muscle Layer in Lower Segment Cesarean Sections to Avoid Uterine Vessels Injury

Ain Shams University

Status: Unknown

Conditions: Cesarean Section Complications

Treatments: Procedure: Transverse cutting; Procedure: vertical splitting

Study type: Interventional

Funder types: Other

Identifiers

NCT03224247

Vertical splitting in CS

Details and patient eligibility

About

Cesarean section is one of the oldest surgical interventions in the history of medicine.Many variations in cesarean section technique have been studied.The investigatory team are aiming to decrease blood loss during cesarean section by vertical splitting versus transverse cutting of muscle layer in lower segment cesarean sections to avoid uterine vessels injury.

Full description

Cesarean section is one of the oldest surgical interventions in the history of medicine.Since the first documented cesarean delivery in 1020 AD, various modifications have been made in the technique. It was a surgery performed as a last resort, mostly peri- or post-portem.

Many variations in cesarean section technique have been studied.our study aim is to decrease blood loss during cesarean section through decreasing incidence of uterine vessels injury. The investigator supposed that applying Vertical pull on a small C-shaped incision in the lower uterine segment during cesarean section allows the tissues to split along their natural arrangement, decreasing the probability of extension of the wound into the uterine vessels, thus; decreasing blood loss; operative time and maternal recovery.

Enrollment: 400 estimated patients

Sex: Female

Ages: 18 to 35 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Elective cesarean section
• No medical disorders during pregnancy ( Hypertension, DM , ..)
• No coagulation disorders either congenital nor acquired.

Exclusion criteria

• Urgent or emergency cesarean section.
• Multiple pregnancy.
• Presence of medical disorders during pregnancy ( Hypertension, DM , ..)
• Presence of coagulation disorders either congenital nor acquired.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

Transverse splitting

Active Comparator group

Description:

transverse cutting and/or pulling of lower uterine segment during lower segment cesarean section.

Treatment:

Procedure: Transverse cutting

Vertical splitting

Active Comparator group

Description:

vertical splitting,of lower uterine segment during lower segment cesarean section.

Treatment:

Procedure: vertical splitting