Intra-abdominal irrigation at cesarean delivery: a randomized controlled trial

Area of Science:

• Obstetrics and Gynecology
• Surgical Innovation
• Patient Safety

Background:

• Intra-abdominal irrigation is sometimes used after cesarean delivery.
• Its impact on patient outcomes, particularly gastrointestinal disturbance and morbidity, requires clarification.

Purpose of the Study:

• To evaluate if omitting intra-abdominal irrigation at cesarean delivery reduces gastrointestinal issues.
• To determine if this change increases postoperative morbidity.

Main Methods:

• A randomized controlled trial involving 236 patients undergoing cesarean delivery.
• Patients were assigned to either intra-abdominal irrigation or no irrigation after hysterotomy closure.
• Primary outcome was intraoperative nausea; secondary outcomes included postoperative gastrointestinal disturbance and infectious morbidity.

Main Results:

• Intraoperative nausea was significantly higher in the irrigation group (46.4%) compared to the no irrigation group (28.26%).
• No significant differences were observed in postoperative nausea, emesis, antiemetic use, or infectious morbidity.
• A trend towards increased postoperative nausea and antiemetic use was noted with irrigation.

Conclusions:

• Intra-abdominal irrigation during cesarean delivery is associated with increased intraoperative nausea.
• Omitting irrigation does not negatively impact postoperative infectious morbidity.
• Avoiding irrigation appears to be a safe and potentially more comfortable practice.