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Closure vs Non-Closure of the Visceral and Parietal Peritoneum at Cesarean Delivery: 16 Year Study

1007

Waraporn Weerawetwat MD*,
Sayan Buranawanich MD*, Manat Kanawong MD*

* Department of Obstetrics and Gynecology, Paholpolpayuhasena Hospital, Kanchanaburi

Abstract


bjective : To determine whether non-closure of visceral and parietal peritoneum at LSCS has advantages over peritoneal closure with regard to postoperative complication and adhesions.
Study design : Prospective randomized controlled trial.
Setting : Paholpolpayuhasena Hospital, Kanchanaburi province, Thailand.
Subjects and Method : Three hundred and sixty full-term pregnant women undergoing first cesarean section were divided into 3 groups (N = 120). Group A: non-closure of both visceral and parietal peritoneum. Group B: non-closure of only visceral peritoneum. Group C: closure of both visceral and parietal peritoneum. Postoperative complications were compared. Adhesions were evaluated in 65 patients returning for a second LSCS and compared for severity of adhesions. The three groups were compared using statistical analysis.
Result : There was no significant statistical difference between group A and C , group B and C for postoperative complications or number of adhesion formation. However, adhesions in the closure group were more severe.
Conclusions : Closure of visceral and parietal peritoneum has no benefit over non-closure of visceral peritoneum and non-closure of both visceral and parietal peritoneum at LSCS.

Keyword : Cesarean delivery, Non-closure peritoneum, Adhesion, 16 year study



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