Related Experiment Video
Updated: May 13, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Evidence-based surgery for cesarean delivery: an updated systematic review
Joshua D Dahlke1, Hector Mendez-Figueroa, Dwight J Rouse
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Warren Alpert School of Medicine of Brown University/Women and Infants Hospital, Providence, RI.
American Journal of Obstetrics and Gynecology
|March 8, 2013
Summary
Updated guidance for cesarean delivery (CD) surgical techniques is available. Evidence supports prophylactic antibiotics, specific uterine closure methods, and spontaneous placental removal to reduce infection morbidity.
Area of Science:
- Obstetrics and Gynecology
- Surgical Innovation
- Evidence-Based Medicine
Background:
- Cesarean delivery (CD) is a common surgical procedure with evolving techniques.
- Previous systematic reviews highlight the need for updated evidence-based guidance on CD surgical aspects.
Purpose of the Study:
- To provide updated, evidence-based recommendations for surgical techniques during cesarean delivery.
- To synthesize findings from recent randomized controlled trials (RCTs) and systematic reviews on CD.
Main Methods:
- Systematic review of English-language MEDLINE, PubMed, and COCHRANE databases.
- Inclusion of RCTs on CD techniques published from January 1, 2005, to September 1, 2012.
- Inclusion of relevant Cochrane reviews, systematic reviews, and meta-analyses.
Main Results:
- Identified 73 RCTs, 10 meta-analyses/systematic reviews, and 12 Cochrane reviews.
- High-certainty recommendations favor prophylactic antibiotics, blunt uterine extension, spontaneous placental removal, and specific uterine closure techniques.
- Recommendations do not favor manual cervical dilation, subcutaneous drains, or supplemental oxygen for infection morbidity reduction.
Conclusions:
- Adoption of high-quality, evidence-based technical aspects of cesarean delivery is recommended.
- Further well-designed trials are warranted to address specific technical aspects of CD.
- Updated guidance aims to optimize surgical decisions and reduce patient morbidity.
