Uterine incision closure at caesarean section: a randomised comparative study of intraperitoneal closure and closure after temporary exteriorisation.

BACKGROUND: The safety of the technique of uterine exteriorization at caesarean section though popular among obstetricians, remains controversial. OBJECTIVE: To evaluate the influence of exteriorization of uterus during uterine repair on caesarean morbidity. METHODS: A randomized comparative study of 136 women undergoing primary caesarean delivery at Havana Specialist Hospital Lagos Nigeria. Data on operation time, estimated blood loss, postoperative morbidities were collected and analysed with comparison between the two groups using chi square, Fischer's exact test and t-test as appropriate. RESULTS: The mean operative time, estimated blood loss, transfusion rate and postoperative anemia rate were significantly less in the exteriorized group than the intraperitoneal group (p = 0.000, 0.009,0.048 0.038 and 0.028 respectively), but not in other outcome measures. CONCLUSION: With shorter operative time, less blood loss and similar morbidity profile exteriorization of uterus during caesarean section seems to be preferred except where it is not possible because of adhesions and surgeons inexperience.