Comparison of intraoperative haemorrhage by blunt versus sharp exapansion of the uterine incision at caesarean section

ABSTRACT

This study compared increased intraoperative blood loss in lower segment caeserean section between blunt versus sharp extension of uterine incision. This comparative analytical study was carried out in Gynaecology and Obstetrics department of Combined Military Hospital Rawalpindi from November 2002 to April 2003. The study comprised of 100 patients who were to undergo lower segment caesarean section out of which 50 patients were allotted in each of the two groups by non-probability convenience sampling. The selection criteria were full term pregnant women with single fetus. The maternal demographics of age, parity, body mass index, pre- operative haaematocrit were similar between the two groups. In the blunt group, the estimated blood loss was 805.80ml+376.95 as compared to 750.40ml+247.97 in the sharp group. It was more in the blunt group but the difference was not significant. There was no cervical tear in the sharp group as compared to four tears [8%] in the blunt group. In conclusion, both methods are comparable regarding amount of intraoperative haemorrhage. The sharp method confers some protection against cervical tears in cases of advanced labour and repeat caesarean section as compared to blunt met