The Misgav Ladach method--a step forward in operative technique in obstetrics.
OBJECTIVE
To investigate the advantage of performing cesarean section using the Misgav-Ladach method and to justify its use in everyday practice.


METHODS
In a prospective study we analyzed over a two year period (2000-01) cesarean sections carried out using the Misgav-Ladach method at our clinic. We compared both 550 cases of Misgav-Ladach (ML) and 100 cases of Pfannenstiel (PH) cesarean section. In the group that had undergone the Misgav-Ladach method we sutured the uterus in one layer and left the peritoneum non-sutured, and in the group who had undergone Pfennenstiel we sutured the uterus in two layers and also sutured the visceral and parietal peritoneum. In every case we analyzed: maternal age, gestational age, duration of operation, consumption of suture material, duration of hospitalization, and surgical complications.


RESULTS
Incidence of postoperative febrile morbidity was 5.45%, in the Misgav-Ladach group compared with 13.2% in the Pfannenstiel group (p < 0.05). Local infection of the wound in the Misgav-Ladach group was found in 4.54% and in the Pfannenstiel group in 9% (p < 0.05). Mean time of extraction of the newborn in the Misgav-Ladach group was 1.25 minutes, and in the Pfannenstiel group 4.10 minutes (P < 0.05). Mean duration of operation in the Misgav-Ladach group was 10.98 min, and in the Pfannenstiel group 25 min (p < 0.05). Mean duration of hospitalization in the Misgav-Ladach group was 4.75 days, and in the Pfannenstiel group 6.32 days (p > 0.05). Mean consumption of suture material in the group Misgav-Ladach was 3.10 sutures per operation, and in the Pfannenstiel group was 9.5 sutures.


CONCLUSIONS
Our study shows that the Misgav-Ladach method of cesarean section enables fast recovery and shorter hospitalization, and reduces the length of the operation, the incidence of surgical complication and the consumption of surgical materials.
Clinic for Gynecology and Obstetrics, University Clinical Center, Tuzla, Bosnia and Herzegovina.
Zlatan
Z
Fatusić
Asim
A
Kurjak
Edin
E
Jasarević
Tomislav
T
Hafner
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D017523:Croatia; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies