Pelosi-type vs. traditional cesarean delivery. A prospective comparison.
OBJECTIVE
To determine the effect of a simplified method of cesarean delivery on postoperative febrile morbidity, operative time, blood loss, total cost and length of hospital stay at Yale New Haven Hospital.


METHODS
From March 22, 1997, until September 26, 1997, 304 consecutive primary low transverse cesarean deliveries were evaluated at Yale New Haven Hospital. The patient age, duration of ruptured membranes, use of prophylactic antibiotics, operative times, blood loss, major complications, analgesic use, diet advancement, length of hospital stay and total cost of hospitalization were recorded for 275 eligible cases.


RESULTS
The Pelosi technique was employed in 101 cases, while 174 were performed with Yale's traditional methods. Both groups were comparable regarding demographic characteristics. Two women in the Pelosi group (1.98%) developed postoperative fevers as compared with 17 (9.77%) in the traditional group (relative risk, 4.93; confidence interval, 1.16, 20.91; P = .05). The mean operating time was 27 minutes in the Pelosi group versus 45 minutes in the traditional group (P = .01). The mean costs were $7,623.55 in the experimental group versus $8,613.28 in the controls (P = .001). No significant differences were seen between the use of prophylactic antibiotics, duration of membrane rupture, analgesic use or hospital stay between the two groups. No serious maternal or fetal outcomes occurred in either group.


CONCLUSIONS
Pelosi-type cesarean delivery resulted in significantly decreased operative time, blood loss and overall cost and improved patient outcome over traditional cesarean section.
Wood
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RM
Department of Obstetrics and Gynecology, Yale University Hospital, New Haven, Connecticut, USA.
Simon
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Oz
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D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D004564:Electrocoagulation; D005260:Female; D005334:Fever; D006801:Humans; D011183:Postoperative Complications; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome