Postpartum clinical evaluation of omission of bladder flap during cesarean section
Abstract
Objective: Cesarean section (C/S) is one of the most common operation performed by the gynecologist throughout the world. The aim of this study is to present our experience in this particular group of patients and compare the early and late outcomes of the patients with and without a bladder flap after a C/S procedure.
Materials and Method: All cases admitted between October 2018 and January 2019 due to C/S were retrieved from hospital electronic medical records. Data were collected on demographics, perioperative test results, operative characteristics, postoperative complications and outcomes. The C/S decision was given by the surgeon per fetal or maternal problems such as placenta previa, ablatio placenta, malpresentation, fetal distress, macrosomia and prolapses of the umbilical cord. Patients were grouped into two as Group 1 comprised patients who had C/S with bladder flap while Group 2 included the patients without bladder flap.
Results: There were 63 patients included in the study with a mean age of 27.87 ± 4. None of the patients in either group had bladder injury. The comparison of the groups demonstrated the group were statistically equal in maternal age, weight, body mass index (BMI) and gestational week. The presence of microhematuria was significantly higher in Group 1 patients (p=0.000, OR 2.55, 95% CI 1.568-4.159) and there was statistically significant decrease in the hemoglobin levels (Group 1 0.91 ± 1.48 vs Group 2 0.13 ± 1.24, p=0.026). However, the decrease in the hematocrit values did not statistical significance (Group 1 1.78 ± 6.84 vs Group 2 0.63 ± 4.09, p=0.423). The postoperative residual urine, on the other hand, was slightly higher in patients with bladder flap.
Conclusion: Bladder flap during C/S has adverse effects on the blood loss, surgical time and postoperative symptoms. Hence, omitting the flap will improve the postoperative comfort both for the patient and the surgeon.
Keywords
caserean, bladder flap, urinary retension, bleeding, outcomes
References
- Sayın Hocam yayınımın en kısa dönemde geri dönüş yapılmasını rica ediyorum. Saygılarımla