Extraabdominal vs intraabdominal uterine repair at cesarean delivery: a metaanalysis.
OBJECTIVE
Cesarean section delivery is a commonly performed surgical procedure, and rates of cesarean delivery are increasing. Previous randomized trials that compared extraabdominal and intraabdominal uterine repair at cesarean section delivery have yielded conflicting results.


METHODS
We conducted a metaanalysis of published randomized controlled trials that addressed the method of uterine repair at cesarean delivery. The primary outcome was incidence of perioperative complications. The secondary outcomes were operative time, estimated blood loss, and hospital stay. Pooled odds ratios were calculated for categoric variables with random effects models. Continuous variables were compared by means of weighted mean differences.


RESULTS
No significant differences in either postoperative or intraoperative complications were demonstrated between the extraabdominal (n = 1605) and intraabdominal repair (n = 1578) groups. Operative time, estimated blood loss, and hospital stay were all unaffected by repair technique. This study cannot exclude differences in rare complications, such as serious venous air embolism or maternal death.


CONCLUSIONS
No differences in complication rates were found between extraabdominal and intraabdominal repair at cesarean section delivery; both techniques are valid surgical options.
Department of Obstetrics and Gynaecology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK. Colin.Walsh@sesiahs.health.nsw.gov.au
Colin A
CA
Walsh
Stewart R
SR
Walsh
D000005:Abdomen; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D013513:Obstetric Surgical Procedures / Q000379:methods; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D014599:Uterus / Q000601:surgery*