title: Higher Incision at Upper Part of Lower Segment Caesarean Section.
abstract: BACKGROUND
  To determine if the upper part of the lower segment of the uterus is a better site for cesarean incision then the traditionally used lower end.
  
  
  METHODS
  This is a case-control study (1:1 ratio) conducted from 1(st) October 2012- 30(th) September 2013 observed between transverse incision at the upper part of the lower segment versus traditional lower segment of the uterus. Two hundred caesarean sections were performed via a transverse uterine incision at the upper part of the lower segment and equal numbers of uterine incision was performed at traditional lower segment. To obtain less intraoperative bleeding high incision made at thicker wider muscular part at of the upper part of lower segment about 2-3 cm distances from vesico-uterine serosa.
  
  
  RESULTS
  The estimated volume of blood loss in high incision 188±60.1 ml was significantly less compared to traditional incision 330.1± 86.5 ml (p<0.05). Duration of operation 30.5± 6.6 minute versus 45.3±7.2 minute and tearing the uterine incision was significantly less with the high incision versus traditional incision. Other procedural and patient benefits are noted.
  
  
  CONCLUSIONS
  An incision at the upper part of the lower segment reduces blood loss, enhances uterine retraction, predisposes to fewer complications, is easier to repair, precludes bladder adhesion to the suture line and reduces operation time.
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Shao
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Pradhan
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D020883:Hysterotomy / Q000009:adverse effects / Q000379:methods*; D007744:Obstetric Labor Complications / Q000209:etiology / Q000517:prevention & control*; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult
keywords: caesarean section; higher incision technique; traditional uterine incision technique.