COMPARISION OF INTRA - OPERATIVE AND POST- OPERATIVE COMPLICATIONS OF INTRA- ABDOMINAL VERSUS EXTRA ABDOMINAL UTERINE REPAIR AT CAESAREAN DELIVERY

Abstract

Objective: To compare intra–operative and postoperative complications between intra-abdominal repair and 
exteriorization of uterus during caesarean delivery.
Study Design: Randomized controlled trial.
Place and Duration of Study: Obstetrics and Gynecology Department of Combined Military Hospital, Quetta
from August 2012 to August 2013.
Material and Methods: A total of 780 women (390 in each group) with an indication for caesarean delivery 
(elective), parity 2 or more with singleton pregnancy at term assessed by dating scan were included in this 
study. In group A uterine incision is repaired while in pelvis (in situ) and In group B uterus is drawn from the 
pelvis to rest on the anterior abdominal wall so that the uterine incision can clearly be visualized
(exteriorization of uterus).
Results: A total of 780 patients were included in the study. Mean age was 27.1 ± 2.7 and 27.4 ± 2.9 years in 
group-A and B, respectively. Gestational age was 37.7 ± 5.2 and 37.2 ± 5.4 weeks in group-A, and B, 
respectively. Surgical time was less than 45 minutes (35.3%) with in situ uterus repair as compared with 44% 
with exteriorization of uterus(p=0.003). Mean time for the first recognized bowl movement was 13.10 ± 3.45 
hours in situ repair and 16.11 ± 4.98 hours in exteriorization of uterus (p<0.001). Exteriorization had been 

Conclusion: Exteriorization of uterus at caesarean section has the advantages of good exposure, good access 
to incision angle. E