Closure versus Non-Closure of the Rectus Muscle at Cesarean Section
Walaa Ahmed Mohamed;
Abstract
Cesarean delivery now is the most common obstetric intraperitoneal operation, and the number of cesarean deliveries is increasing worldwide.
The leading indications for cesarean delivery are previous cesarean delivery, breech presentation, dystocia, and fetal distress. These indications are responsible for 85% of all cesarean deliveries.
It is most common to classify c-sections by the urgency of performing them. When there is something unusual about the mother or the pregnancy, then it becomes common to classify that c-section by whatever unusual characteristics are seen. When discussing the actual technique or surgical conditions, then c-sections are classified by those techniques.
There are several types of Caesarean section (CS). An important distinction lies in the type of incision (longitudinal or latitudinal) made on the uterus, apart from the incision on the skin.
A variety of surgical techniques for all elements of the cesarean section operation is in use. Many have not yet been rigorously evaluated in randomized controlled trials and it is not known whether any are associated with better outcomes for women and babies.
Despite this, there is no widely accepted technique for performing cesarean section, numerous approaches have been described and technique often varies from surgeon to surgeon.
Few steps in a cesarean delivery are based on level I data, whereas many steps have limited or no evidence. Techniques that are supported by medical evidence include the use of a first or second-generation cephalosporin for pre-incision preoperative antibiotic prophylaxis, entering the abdomen with a Joel-Cohen technique, expanding the uterine incision bluntly, delivering the placenta spontaneously, closing the subcutaneous space in obese women, and suturing the skin incision. The rectus muscles are occasionally re-approximated at the time of cesarean delivery to decrease the risk of abdominal wall diathesis. Our search did not identify studies that evaluate the efficacy of rectus muscle closure at the time of cesarean delivery in preventing abdominal wall diathesis or its effects on postoperative pain, healing, or adhesion formation.
The current study is a randomized controlled trial. It was conducted at the Labor/delivery wards at Ain Shams University Maternity Hospital and El-Galaa Teaching Hospital during the interval between January 2015 and July 2015.
The leading indications for cesarean delivery are previous cesarean delivery, breech presentation, dystocia, and fetal distress. These indications are responsible for 85% of all cesarean deliveries.
It is most common to classify c-sections by the urgency of performing them. When there is something unusual about the mother or the pregnancy, then it becomes common to classify that c-section by whatever unusual characteristics are seen. When discussing the actual technique or surgical conditions, then c-sections are classified by those techniques.
There are several types of Caesarean section (CS). An important distinction lies in the type of incision (longitudinal or latitudinal) made on the uterus, apart from the incision on the skin.
A variety of surgical techniques for all elements of the cesarean section operation is in use. Many have not yet been rigorously evaluated in randomized controlled trials and it is not known whether any are associated with better outcomes for women and babies.
Despite this, there is no widely accepted technique for performing cesarean section, numerous approaches have been described and technique often varies from surgeon to surgeon.
Few steps in a cesarean delivery are based on level I data, whereas many steps have limited or no evidence. Techniques that are supported by medical evidence include the use of a first or second-generation cephalosporin for pre-incision preoperative antibiotic prophylaxis, entering the abdomen with a Joel-Cohen technique, expanding the uterine incision bluntly, delivering the placenta spontaneously, closing the subcutaneous space in obese women, and suturing the skin incision. The rectus muscles are occasionally re-approximated at the time of cesarean delivery to decrease the risk of abdominal wall diathesis. Our search did not identify studies that evaluate the efficacy of rectus muscle closure at the time of cesarean delivery in preventing abdominal wall diathesis or its effects on postoperative pain, healing, or adhesion formation.
The current study is a randomized controlled trial. It was conducted at the Labor/delivery wards at Ain Shams University Maternity Hospital and El-Galaa Teaching Hospital during the interval between January 2015 and July 2015.
Other data
| Title | Closure versus Non-Closure of the Rectus Muscle at Cesarean Section | Other Titles | مقارنة النتائج التابعة لخياطة عضلات البطن المستقيمة أثناء الولادة القيصرية من عدمه | Authors | Walaa Ahmed Mohamed | Issue Date | 2015 |
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