COMPARISON OF INTRA OPERATIVE HEMORRHAGE BY BLUNT AND SHARP EXPANSION OF UTERINE INCISION AT CESAREAN SECTION

Background and Objective: the rate of cesarean section has increased over the past many years. different techniques are used to reduce blood loss at cesarean section. The purpose of this study is to compare the effect of blunt and sharp uterine incision at the cesarean section on mean maternal blood loss.
Methodology: This randomized controlled trial was conducted in the department of Gynecology/obstetrics, POF Hospital, Wah Cantt from 14th Jan to 13th July 2014. Eighty women scheduled for lower segment cesarean section were randomized to either blunt uterine incision (n=40) or sharp uterine incision (n=40). Outcomes were noted in terms of Peri-operativehematocrit fall and Hemoglobin fall were noted in two groups and analyzed with help of SPSS version 10.
Results: There was a significant decrease in mean perioperative hematocrit and hemoglobin in sharp uterine incision as compared to blunt uterine incision and the difference between the two is found to be statistically significant. Perioperative hematocrit fall in group A was (mean 3.21±SD 1.3)and perioperative hematocrit fall was (mean 4.2 ± SD2.17) in group B. The difference between the two groups was statistically significant-value=0.015(<0.05). More fall was seen in group B as compared to group A. Perioperativehemoglobin fall (mean ±SD) was (1.47±1.08) in group A versus (mean1.95 ± SD0.85)in group B. The difference was statistically significant among two groups with p-value =0.031(<0.05)
Conclusion: Blunt expansion of uterine incision during lower segment cesarean section is better as it is associated with less hemoglobin and hematocrit fall than the sharp uterine incision.
Keywords: Caesarean section, blunt uterine incision, sharputerine incision.