title: [Blunt or sharp expansion of cesarean section: a comparative study].
abstract: OBJECTIVE
  The aim of this study was to determine if the method used to expand the hysterotomy during a cesarean section (c-section) could affect maternal blood loss and uterine laceration.
  
  
  METHODS
  Prospective study including 214 c-sections divided into two groups. Hundred and thirty-six were assigned to have blunt expansion of the uterine incision (group 1) and 78 to have sharp expansion by scissors (group 2). Maternal blood loss, change in hemoglobin level, and uterine tears were studied.
  
  
  RESULTS
  The median blood loss was (IQR) 475mL (300-700) and 500mL (300-800) (P=0.227) in groups 1 and 2 respectively. The decrease in hemoglobin level was 9.5g/L versus 6g/L (P=0.007) in groups 1 and 2. Nine lateral uterine extensions of uterine incision (5.88%) were found in the group 1, three of them were complicated by a wound of the uterine vascular pedicle. One lateral uterine tear with vascular wound was found in the group 2 (1.28%).
  
  
  CONCLUSIONS
  Sharp expansions were associated with a lower shift in hemoglobin level and a trend to more uterine lacerations.
authors: Maternité de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69004 Lyon, France. b.chicaud@gmail.com
authors: B
authors: B
authors: Chicaud
authors: C
authors: C
authors: Roux
authors: R-C
authors: RC
authors: Rudigoz
authors: C
authors: C
authors: Huissoud
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005385:Fingers; D006801:Humans; D020883:Hysterotomy / Q000295:instrumentation* / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D013525:Surgical Instruments / Q000009:adverse effects; D014599:Uterus / Q000293:injuries / Q000601:surgery*