Modified Joel-Cohen technique for caesarean delivery

Authors


Correspondence: Dr G. Wallin, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, S-416 85 Gothenburg, Sweden.

Abstract

Objective To investigate whether a series of changes in the current caesarean section operative routine, based on new knowledge, would be beneficial.

Design A prospective controlled trial.

Setting Labour ward with approximately 3000 deliveries annually in a suburban area of Gothenburg, Sweden.

Participants Seventy-two pregnant women scheduled for delivery by caesarean section were randomised to either modified Joel-Cohen technique (n= 36) or Pfannenstiel technique (n= 36).

Main outcome measures Blood loss during surgery and operating time.

Results based on new knowledge, would be beneficial. The median estimated intra-operative blood loss was 250 mL in the modified Joel-Cohen group and 400 mL in the Pfannenstiel group (P= 0.026). The proportion of women with 2 300 mL was 16/36 in the modified Joel-Cohen group vs 28/36 in the Pfannenstiel group (OR 0.229,95% CI 0.082–0.637). Median operating time was 20 min in the modified Joel-Cohen group compared with 28 min in the Pfannenstiel group (P < 0.001). The proportion of women with 2 25 min was 1/36 in the modified Joel-Cohen group vs 33/36 in the Pfannenstiel group (OR 0.003, 95% CI Conclusions We conclude that the modified Joel-Cohen technique of caesarean delivery reduced intra 0.000–0.026).

Conclusions We conclude that the modified Joel-Cohen technique of caesarean delivery reduced intra-operative blood loss and operating time compared with the Pfannenstiel technique.

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