Maternal blood loss by mode of uterine incision at caesarean section: A comparison between sharp and blunt techniques

Abstract

Objective: To evaluate the effect of two techniques of uterine incision expansion at caesarean section on the maternal blood loss, inadvertent extension of incisions and the feto-maternal outcome .
Methods: A quasi-experimental study with convenient sampling involving two groups of women who underwent lower segment transverse caesarean section. Both groups were studied for their demographic characteristics and clinical data. Standard surgical techniques were used in both groups except the technique of uterine incision either by blunt or sharp method. Finally a comparison of the two groups was made regarding blood loss, changes in haemotocrit, blood transfusion and uterine tears. The study was conducted at the obstetric unit of Obafemi Awolowo University teaching Hospital Ile-Ife, Nigeria from January to December 2006.
Result: Seventy-two women were studied (36 into either method). Blunt method of uterine expansion was significantly associated with in creased risk for blood loss, fall in haematocrit (P=0.001), need for blood transfusion (P<0.05) and uterine, vaginal and cervical tears due to  inadvertent extension compared to sharp expansion group.
Conclusion: The sharp expansion method is recommended because it is associated with reduced maternal morbidity in term of blood loss and uterine tears