Uterine exteriorization versus intraperitoneal repair at caesarean section.
BACKGROUND
After caesarean delivery of the fetus and placenta, the uterus may be placed outside the mother to facilitate repair of the uterine incision.


OBJECTIVE
The objective of this review was to assess the effects of exteriorisation of the uterus, compared to the effects of uterine closure within the abdominal cavity.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group trials register.


METHODS
Randomised and quasi-randomised trials of uterine exteriorisation for repair compared to intra-abdominal repair for pregnant women undergoing elective or emergency caesarean section.


METHODS
Two reviewers assessed trial quality and extracted the data.


RESULTS
Two trials involving 486 women were included. Neither trial was methodologically strong. Exteriorisation made no significant difference to blood loss. Exteriorisation was associated with fewer post-operative febrile days (fever more than three days, odds ratio 0.40, 95% confidence interval 0.17 to 0.94) and a non-significant trend towards fewer infections. There was also a non-significant trend towards more nausea and vomiting when exteriorisation was done under regional analgesia.


CONCLUSIONS
There is not enough information to evaluate the routine use of exteriorisation of the uterus for repair of the uterine incision.
Wilkinson
C
C
Department of Perinatal Medicine/University Department of Obstetrics & Gynaecology, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, Australia, 5006. cwilkins@medicine.adelaide.edu.au
Enkin
M W
MW
D002585:Cesarean Section / Q000379:methods; D005260:Female; D006801:Humans; D011247:Pregnancy; D014599:Uterus