Objective: Comparison of some outcomes of two techniques for expansion of the low transverse uterine incision at cesarean section
Design: Clinical Trial, Single blind, Control with standard technic of surgery, Unicenter
Population: All women who are candidate for cesarean section
Inclusion criteria: All women with singleton pregnancy and term gestational age who give informed constsnt for our research
Exclusion criteria: Unknown gestational age, preterm or postterm pregnancy, placenta previa, abruptio placenta, severe hemorrhage before cesarean section, polyhydramnios, connective tissue disorders, estimated fetal weight greater than 4000 gr, uterine atony during or after cesarean section
Interventions: Transverse and cephalad cauded blunt expansion of the low transverse uterine incision at cesarean section
Main outcome measures: Unwanted extension of uterine incision, Need to blood transfusion, Assessment of intraoperation blood loss
At first data form including name, age, gravidity, gestational age, and indication of cesarean section will be completed for all participants .Then they will be assigned to blunt expansion of the uterine incision with transverse traction or cephalad cauded group by quad blocks. Hematocrit will be assessed just before and 6 hours after operation. Surgery will be done under general or spinal anesthesia (based on indication) and all operative procedures will be performed similarly before the uterine incision . A transverse uterine incision in the uterine segment of 1 to 2 cm will be expanded by the designated method. In case group, opening of the lower uterine segment will be created by separation of the index fingers of the surgeon in a cephalad cauded direction along the midline but in the control group the incision will be extended by lateral and upward pressure applied with index fingers.