The Effect of Omission of the Bladder Flap Formation at Lower Segment Cesarean Delivery: A Randomized Controlled Trial

• 作者: Ahmed A. Youssef Ahmed M. Abbas Elwany Elsenosy Tarek A. Farghaly Yasmeen A. Youssef
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: Cesarean Section BLADDER FLAP HEMATURIA LOWER SEGMENT
• 年，卷（期）: 2019,（8）
• 页码范围: 1083-1091
• 页数: 9页
• 分类号: R73

摘要

Background: This study aims to evaluate the effects of omission of the bladder flap formation at primary and repeat lower segment CS. Patients and Methods: The current study was randomized controlled trial conducted in Women Health Hospital, Assiut University, Egypt between March 2017 and May 2018 (ClinicalTrial.gov NCT03016273). Patients were divided into: Non bladder flap group: Uterine incision made 1 cm above the vesico-uterine reflection without incision and dissection of the bladder peritoneum and bladder flap group: Standard cesarean section technique with incision and dissection of a bladder flap prior to uterine incision. Results: The study included 150 patients (75 in each arm). The most common indication for CS in both groups was repeated CS. Non-bladder flap group, compared with flap group, showed shorter skin-incision to delivery time and total operative time, and significantly lower mean estimated blood loss and postoperative pain score. Non-bladder flap group, compared with flap group, was more likely to show postoperative microhematuria. The two groups required approximately the same time for post-operative defecation. Conclusion: Omission of bladder flap formation during CS is associated with shorter operative time, less blood loss, less postoperative pain and lower incidence of postoperative hematuria.