Surgical techniques used during caesarean section operations: results of a national survey of practice in the UK.
OBJECTIVE
To determine what surgical techniques are used by obstetricians in the UK for elective and emergency caesarean section operations.


METHODS
A postal questionnaire to all members and fellows of the Royal College of Obstetricians and Gynaecologists (RCOG) resident in the UK, requesting information about the use of surgical techniques and antibiotic and anticoagulant prophylaxis for elective and emergency caesarean sections.


RESULTS
The response rate was 78.7%. A range of techniques was used for all procedures in caesarean section operations. Only a few techniques were used by more than 80% of obstetricians, including double layer closure of the uterus, use of prophylactic antibiotics and Pfannenstiel abdominal entry (for elective caesarean sections). There were few large differences in practice between elective and emergency caesarean sections. In emergency operations, more obstetricians use the Joel-Cohen method of abdominal entry (32.7 versus 16%) and more usually use prophylactic antibiotics and heparin (93.2 versus 85.4% and 45.8 versus 32.9%, respectively).


CONCLUSIONS
There was wide variation in the surgical techniques used by obstetricians for caesarean section operations. There is an urgent need for future research to evaluate many aspects of caesarean section operations on substantive short- and long-term outcomes.
Tully
Lucy
L
National Perinatal Epidemiology Unit, Institute of Health Sciences, Old Road, Oxfrod OX3 7LF, UK.
Gates
Simon
S
Brocklehurst
Peter
P
McKenzie-McHarg
Kirstie
K
Ayers
Sarah
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D000925:Anticoagulants / Q000627:therapeutic use; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D006113:United Kingdom
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D006493:Heparin