[Comparison of pregnancy outcomes Caesarean techniques: modified Misgav-Ladach, Pfannenstiel-Kerr and Kerr-half...

In Mexico, the prevalence of caesarean section is 40.9% in the health sector, the techniques used are the traditional Pfannenstiel-Kerr and Kerr-half infraumbilical and little experience with this new technique Misgav-Ladach modified.

To compare pregnancy outcomes (surgical and fetal extraction time, bleeding, postoperative pain, surgical wound infection, maternal and fetal death) caesarean section techniques modified Misgav-Ladach, Pfannenstiel-Kerr and infraumbilical.

Clinical trial in primiparous women with term pregnancy treated at the Medical Unit of High Specialty 23 of the Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico. Misgav-Ladach caesarean Caesarean modified and Kerr, the latter subdivided into two groups: infraumbilical Pfannenstiel incision and incision half-Kerr two groups patients were randomized.

137 gilts were studied, with term pregnancy and BMI between 19 and 24.9 kg / m2. Caesarean modified Misgav-Ladach 68 patients and 69 classical Kerr (35 Pfannenstiel-Kerr and 34 infraumbilical) was performed. The surgical time in minutes was lower with modified Misgav-Ladach: 27.8 ± 8.0, Pfannenstiel-Kerr recorded 51.7 ± 12.1 and 12.0 ± infraumbilical media48.3 (p = 0.000). The time in seconds fetal extraction was lower in modified Misgav-Ladach: 96.2 ± 68.3, 474.9 ± Pfannenstiel-Kerr 294.1 and 423.2 ± 398.6 infraumbilical (p = 0.000). The trasoperatory milliliters bleeding was lower with modified Misgav-Ladach: 298.5 ± 57.3, 354.3 ± Pfannenstiel-Kerr 98.0 and 355.9 ± 110.6 infraumbilical (p = 0.001). Postoperative pain assessed with the visual analog scale in the first 24 hours was lower with modified Misgav-Ladach: 4.4 ± 1.9, 5.7 ± Pfannenstiel-Kerr and IK 2.1 6.1 ± 2.0 (p = 0.000). The start of the oral route and ambulation Nwas soon comparing modified Misgav-Ladach against Pfannenstiel-Kerr and Kerr-infraumbilical (p = 0.000). The prevalence of fever was 5.9% with modified Misgav-Ladach, 5.9% Pfannenstiel-Kerr and 32.4% withinfraumbilical-Kerr (p = 001). The discharge in hours was modified Misgav-Ladach ± 45.8 to 12.1 h, Pfannenstiel-Kerr 49.3 ± 12.3 h and 58.5 infraumbilical-Kerr ± 21.5 h (p = .000). In this study no maternal or fetal deaths were observed.

Surgical time, bleeding, postoperative pain, better postoperative recovery and shorter hospital stays and less infection were significantly lower than with conventional techniques of caesarean Nsection or infraumbilical-Kerr technique.