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Peritoneal non-closure at caesarean section
1Department of Perinatal Medicine/University Department of Obstetrics & Gynaecology, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, Australia, 5006. cwilkins@medicine adelaide.edu.au.
Background:
It has been suggested that the peritoneal suture might be omitted during caesarean section without adverse effects.
Objectives:
The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intra-operative and immediate postoperative outcomes.
Search Strategy:
We searched the Cochrane Pregnancy and Childbirth Group trials register.
Selection Criteria:
Controlled trials comparing leaving the visceral and/or parietal peritoneum unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section.
Data Collection And Analysis:
Trial quality was assessed and data were extracted by two reviewers.
Main Results:
Four trials involving 1194 women were included. Non-closure of the peritoneum saved operating time (weighted mean difference of -6.12 minutes, 95% confidence interval -8.00 to -4.27) with no significant differences in postoperative morbidity, analgesic requirements and length of hospital stay. There was a consistent, although nonsignificant, trend for improved immediate postoperative outcome if the peritoneum was not closed.
Reviewer'S Conclusions:
There seems to be no significant difference in short term morbidity from non-closure of the peritoneum at caesarean section.