title: The Misgav-Ladach method of cesarean section: a step forward in operative technique in obstetrics.
abstract: OBJECTIVE
  The objective of this study is to compare the intraoperative and short-term outcomes of two cesarean techniques: the modified Misgav-Ladach and the Pfannenstiel-Kerr.
  
  
  METHODS
  We performed a prospective observational cohort study of women undergoing a primary cesarean at the Clinic for Obstetric and Gynecology Tuzla, Bosnia and Herzegovina, between January 2003 and December 2011. The two cesarean techniques were compared for intraoperative and short terms outcomes.
  
  
  RESULTS
  A total of 4,944 women were included in this study, 4,336 allocated to the modified Misgav-Ladach and 608 to the Pfannenstiel-Kerr techniques. The rate of modified Misgav-Ladach increased from 74 % in 2003 to 99 % in 2011. The modified Misgav-Ladach technique was associated with a shorter operative time (13.3 min ± 7.4 vs. 19.1 min ± 6.8, p < 0.05), as well as significantly less surgical material (3.5 ± 2.5 vs. 7.9 ± 2.1, p < 0.05). The modified Misgav-Ladach technique was also associated with lower analgesic requirements, lower rates of febrile morbidity and wound infection compared to the Pfannenstiel-Kerr technique (p < 0.05). No significant differences were observed in the incidence of endometritis, wound dehiscence, bowel restitution, postoperative antibiotic use, and hospital stay.
  
  
  CONCLUSIONS
  The modified Misgav-Ladach technique is associated with a shorter operative time than Pfannenstiel-Kerr and might lead to better postoperative outcomes.
authors: Clinic for Gynecology and Obstetrics, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and Herzegovina. i.hudic@bih.net.ba
authors: Igor
authors: I
authors: Hudić
authors: Emmanuel
authors: E
authors: Bujold
authors: Zlatan
authors: Z
authors: Fatušić
authors: Fahrija
authors: F
authors: Skokić
authors: Anela
authors: A
authors: Latifagić
authors: Mirela
authors: M
authors: Kapidžić
authors: Jasenko
authors: J
authors: Fatušić
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods* / Q000639:trends; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D061646:Operative Time; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D055815:Young Adult
chemical_list: D000700:Analgesics