title: Modified Joel-Cohen technique for caesarean delivery.
abstract: OBJECTIVE
  To investigate whether a series of changes in the current caesarean section operative routine, based on new knowledge, would be beneficial.
  
  
  METHODS
  A prospective controlled trial.
  
  
  METHODS
  Labour ward with approximately 3000 deliveries annually in a suburban area of Gothenburg, Sweden.
  
  
  METHODS
  Seventy-two pregnant women scheduled for delivery by caesarean section were randomised to either modified Joel-Cohen technique (n = 36) or Pfannenstiel technique (n = 36).
  
  
  METHODS
  Blood loss during surgery and operating time.
  
  
  RESULTS
  The median estimated intra-operative blood loss was 250 mL in the modified Joel-Cohen group and 400 mL in the Pfannenstiel group (P = 0.026). The proportion of women with > or = 300 mL was 16/36 in the modified Joel-Cohen group vs 28/36 in the Pfannenstiel group (OR 0.229, 95% CI 0.082-0.637). Median operating time was 20 min in the modified Joel-Cohen group compared with 28 min in the Pfannenstiel group (P < 0.001). The proportion of women with > or = 25 min was 1/36 in the modified Joel-Cohen group vs 33/36 in the Pfannenstiel group (OR 0.003, 95% CI 0.000-0.026).
  
  
  CONCLUSIONS
  We conclude that the modified Joel-Cohen technique of caesarean delivery reduced intraoperative blood loss and operating time compared with the Pfannenstiel technique.
authors.affiliation: Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Wallin
authors.forename: O
authors.initials: O
authors.lastname: Fall
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods; D000775:Anesthesia, Spinal; D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010149:Postoperative Pain; D011247:Pregnancy; D011446:Prospective Studies