Research Article
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Year 2025, Volume: 42 Issue: 3, 247 - 252, 30.09.2025

Abstract

References

  • Mathai M, Hofmeyr GJ, Mathai NE. Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev. 2013;(5).
  • Chauhan S, PK SD. A randomized comparative study of exteriorization of uterus versus in situ intra-peritoneal repair at cesarean delivery. Int J Reprod Contracept Obstet Gynecol. 2018;7(1):281-287.
  • El-Khayat W, Elsharkawi M, Hassan A. A randomized controlled trial of uterine exteriorization versus in situ repair of the uterine incision during cesarean delivery. Int J Gynecol Obstet. 2014;127(2):163-166.
  • Nafisi S. Influence of uterine exteriorization versus in situ repair on post-cesarean maternal pain: a randomized trial. Int J Obstet Anesth. 2007;16(2):135-138.
  • Das S, Das P, Mahli A, Biswas S. Comparative study of uterine repair during caesarean section–intra-abdominal vs exteriorisation of uterus. ISORJDMS. 2015;14(1):05-8.
  • Mohamed Ali Elwany I, El-Tamamy AER, Hamdy Mohamed A. Comparison between uterine exteriorization and in- situ repair of uterus in caesarian section. Al-Azhar Med J. 2022;51(2):939-952.
  • Cromi A, Ghezzi F, Di Naro E, Siesto G, Loverro G, Bolis P. Blunt expansion of the low transverse uterine incision at cesarean delivery: a randomized comparison of 2 techniques. Am J Obstet Gynecol. 2008;199(3):292-e1.
  • Morales A, Reyes O, Cárdenas G. Type of blunt expansion of the low transverse uterine incision during caesarean section and the risk of postoperative complications: a prospective randomized controlled trial. J Obstet Gynaecol Can. 2019;41(3):306-311.
  • Dikmen S, Gedikbaşı A, Kıyak H, Köroğlu N. The outcomes of extending uterine incision transversely or cephalocaudally in patients with previous cesarean section: a prospective randomized controlled study. Perinatal J. 2017;25(1):1-5.
  • Çekiç G, Çetin S, Gedikbaşı B, Kıyak A, Köroğlu N. Primer sezaryen olan hastalarda Kerr insizyonunun transvers ya da sefalokaudal yönde genişletilmesinin karşılaştırılması: Prospektif randomize kontrollü çalışma. Turkiye Klinikleri Jinekoloji Obstetrik Derg. 2017;27(2):57-63.
  • Ozcan P, Ates S, Guner Can M, Sarioglu Yardımcı A, Batmaz G, Kilic G. Is cephalad-caudad blunt expansion of the low transverse uterine incision really associated with less uncontrolled extensions to decrease intra-operative blood loss? A prospective randomised-controlled trial. J Matern Fetal Neonatal Med. 2016;29(12):1952-1956.
  • Gode F, Okyay RE, Saatli B, Ertugrul C, Guclu S, Altunyurt S. Comparison of uterine exteriorization and in situ repair during cesarean sections. Arch Gynecol Obstet. 2012;285(6):1541-1545.
  • Doğanay M, Tonguc EA, Var T. Effects of method of uterine repair on surgical outcome of cesarean delivery. Int J Gynecol Obstet. 2010;111(2):175-178.
  • Coutinho IC, de Amorim MMR, Katz L, de Ferraz ÁAB. Uterine exteriorization compared with in situ repair at cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2008;111(3):639-647.
  • Abdellah MS, Abbas AM, Ali MK, Mahmoud A, Abdullah SA. Uterine exteriorization versus intraperitoneal repair: effect on intraoperative nausea and vomiting during repeat cesarean delivery–a randomized clinical trial. Facts Views Vis Obgyn. 2018;10(3):131.
  • Orji EO, Olaleye AO, Loto OM, Ogunniyi SO. A randomised controlled trial of uterine exteriorisation and non‐ exteriorisation at caesarean section. Aust N Z J Obstet Gynaecol. 2008;48(6):570-574.
  • Bharathi KR, Mahendra G, Vindhyshree S, Sherawath S. A comparative study of exteriorization and intraperitoneal closure of uterus in caesarean delivery. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5415-5420.
  • Kashif S, Hanif A. Comparison of primary outcomes in extra-abdominal versus intra-abdominal uterine repair at caesarean section: a comparative study. Life Sci. 2022;3(2):04-04.
  • Mahawerawat S, Jeerasap R. Comparison of unintended uterine extension between cephalad-caudad and transverse blunt expansion techniques for low transverse cesarean delivery. Thai J Obstet Gynaecol. 2010;120-125.
  • Zaphiratos V, George RB, Boyd JC, Habib AS. Uterine exteriorization compared with in situ repair for cesarean delivery: a systematic review and meta-analysis. Can J Anesth. 2015;62(11):1209-1220.

How surgical technique influences maternal and neonatal outcomes in elective cesarean sections?

Year 2025, Volume: 42 Issue: 3, 247 - 252, 30.09.2025

Abstract

ABSTRACT
This study examines the impact of different surgical techniques on maternal and neonatal outcomes in elective cesarean sections, addressing the need for optimized methods amid the global rise in cesarean deliveries. Conducted at Ordu University Faculty of Medicine, the research involved 200 patients divided into four groups based on surgical techniques: cranio-caudal vs. transverse uterine incision extensions and intra-abdominal vs. extra-abdominal suturing. Emergency cesareans and cases with specific medical conditions were excluded, and all procedures were performed by a single surgeon to ensure consistency.Key findings reveal that cranio-caudal incision extension and intra-abdominal suturing significantly reduce operative time and postoperative pain, leading to faster recovery without compromising neonatal outcomes. These techniques also resulted in quicker bowel function recovery and required fewer additional sutures compared to transverse incisions. Statistical analysis showed no significant differences in postoperative hemoglobin levels, neonatal Apgar scores, or birth weights among the groups. However, intra-abdominal suturing was associated with shorter operation times and lower pain scores, making it a preferable option.The study concludes that adopting cranio-caudal incision extension and intra-abdominal suturing can enhance operative efficiency and patient recovery in cesarean deliveries. Further research is recommended to confirm the optimal surgical approach with minimal morbidity and mortality. This research contributes to refining cesarean section techniques, potentially setting a new standard for clinical practice.

References

  • Mathai M, Hofmeyr GJ, Mathai NE. Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev. 2013;(5).
  • Chauhan S, PK SD. A randomized comparative study of exteriorization of uterus versus in situ intra-peritoneal repair at cesarean delivery. Int J Reprod Contracept Obstet Gynecol. 2018;7(1):281-287.
  • El-Khayat W, Elsharkawi M, Hassan A. A randomized controlled trial of uterine exteriorization versus in situ repair of the uterine incision during cesarean delivery. Int J Gynecol Obstet. 2014;127(2):163-166.
  • Nafisi S. Influence of uterine exteriorization versus in situ repair on post-cesarean maternal pain: a randomized trial. Int J Obstet Anesth. 2007;16(2):135-138.
  • Das S, Das P, Mahli A, Biswas S. Comparative study of uterine repair during caesarean section–intra-abdominal vs exteriorisation of uterus. ISORJDMS. 2015;14(1):05-8.
  • Mohamed Ali Elwany I, El-Tamamy AER, Hamdy Mohamed A. Comparison between uterine exteriorization and in- situ repair of uterus in caesarian section. Al-Azhar Med J. 2022;51(2):939-952.
  • Cromi A, Ghezzi F, Di Naro E, Siesto G, Loverro G, Bolis P. Blunt expansion of the low transverse uterine incision at cesarean delivery: a randomized comparison of 2 techniques. Am J Obstet Gynecol. 2008;199(3):292-e1.
  • Morales A, Reyes O, Cárdenas G. Type of blunt expansion of the low transverse uterine incision during caesarean section and the risk of postoperative complications: a prospective randomized controlled trial. J Obstet Gynaecol Can. 2019;41(3):306-311.
  • Dikmen S, Gedikbaşı A, Kıyak H, Köroğlu N. The outcomes of extending uterine incision transversely or cephalocaudally in patients with previous cesarean section: a prospective randomized controlled study. Perinatal J. 2017;25(1):1-5.
  • Çekiç G, Çetin S, Gedikbaşı B, Kıyak A, Köroğlu N. Primer sezaryen olan hastalarda Kerr insizyonunun transvers ya da sefalokaudal yönde genişletilmesinin karşılaştırılması: Prospektif randomize kontrollü çalışma. Turkiye Klinikleri Jinekoloji Obstetrik Derg. 2017;27(2):57-63.
  • Ozcan P, Ates S, Guner Can M, Sarioglu Yardımcı A, Batmaz G, Kilic G. Is cephalad-caudad blunt expansion of the low transverse uterine incision really associated with less uncontrolled extensions to decrease intra-operative blood loss? A prospective randomised-controlled trial. J Matern Fetal Neonatal Med. 2016;29(12):1952-1956.
  • Gode F, Okyay RE, Saatli B, Ertugrul C, Guclu S, Altunyurt S. Comparison of uterine exteriorization and in situ repair during cesarean sections. Arch Gynecol Obstet. 2012;285(6):1541-1545.
  • Doğanay M, Tonguc EA, Var T. Effects of method of uterine repair on surgical outcome of cesarean delivery. Int J Gynecol Obstet. 2010;111(2):175-178.
  • Coutinho IC, de Amorim MMR, Katz L, de Ferraz ÁAB. Uterine exteriorization compared with in situ repair at cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2008;111(3):639-647.
  • Abdellah MS, Abbas AM, Ali MK, Mahmoud A, Abdullah SA. Uterine exteriorization versus intraperitoneal repair: effect on intraoperative nausea and vomiting during repeat cesarean delivery–a randomized clinical trial. Facts Views Vis Obgyn. 2018;10(3):131.
  • Orji EO, Olaleye AO, Loto OM, Ogunniyi SO. A randomised controlled trial of uterine exteriorisation and non‐ exteriorisation at caesarean section. Aust N Z J Obstet Gynaecol. 2008;48(6):570-574.
  • Bharathi KR, Mahendra G, Vindhyshree S, Sherawath S. A comparative study of exteriorization and intraperitoneal closure of uterus in caesarean delivery. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5415-5420.
  • Kashif S, Hanif A. Comparison of primary outcomes in extra-abdominal versus intra-abdominal uterine repair at caesarean section: a comparative study. Life Sci. 2022;3(2):04-04.
  • Mahawerawat S, Jeerasap R. Comparison of unintended uterine extension between cephalad-caudad and transverse blunt expansion techniques for low transverse cesarean delivery. Thai J Obstet Gynaecol. 2010;120-125.
  • Zaphiratos V, George RB, Boyd JC, Habib AS. Uterine exteriorization compared with in situ repair for cesarean delivery: a systematic review and meta-analysis. Can J Anesth. 2015;62(11):1209-1220.
There are 20 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Turan Kaan Karakaya 0000-0001-7730-7690

Deha Denizhan Keskin 0000-0002-6108-7619

Publication Date September 30, 2025
Submission Date January 3, 2025
Acceptance Date August 10, 2025
Published in Issue Year 2025 Volume: 42 Issue: 3

Cite

APA Karakaya, T. K., & Keskin, D. D. (2025). How surgical technique influences maternal and neonatal outcomes in elective cesarean sections? Deneysel Ve Klinik Tıp Dergisi, 42(3), 247-252.
AMA Karakaya TK, Keskin DD. How surgical technique influences maternal and neonatal outcomes in elective cesarean sections? J. Exp. Clin. Med. September 2025;42(3):247-252.
Chicago Karakaya, Turan Kaan, and Deha Denizhan Keskin. “How Surgical Technique Influences Maternal and Neonatal Outcomes in Elective Cesarean Sections?”. Deneysel Ve Klinik Tıp Dergisi 42, no. 3 (September 2025): 247-52.
EndNote Karakaya TK, Keskin DD (September 1, 2025) How surgical technique influences maternal and neonatal outcomes in elective cesarean sections? Deneysel ve Klinik Tıp Dergisi 42 3 247–252.
IEEE T. K. Karakaya and D. D. Keskin, “How surgical technique influences maternal and neonatal outcomes in elective cesarean sections?”, J. Exp. Clin. Med., vol. 42, no. 3, pp. 247–252, 2025.
ISNAD Karakaya, Turan Kaan - Keskin, Deha Denizhan. “How Surgical Technique Influences Maternal and Neonatal Outcomes in Elective Cesarean Sections?”. Deneysel ve Klinik Tıp Dergisi 42/3 (September2025), 247-252.
JAMA Karakaya TK, Keskin DD. How surgical technique influences maternal and neonatal outcomes in elective cesarean sections? J. Exp. Clin. Med. 2025;42:247–252.
MLA Karakaya, Turan Kaan and Deha Denizhan Keskin. “How Surgical Technique Influences Maternal and Neonatal Outcomes in Elective Cesarean Sections?”. Deneysel Ve Klinik Tıp Dergisi, vol. 42, no. 3, 2025, pp. 247-52.
Vancouver Karakaya TK, Keskin DD. How surgical technique influences maternal and neonatal outcomes in elective cesarean sections? J. Exp. Clin. Med. 2025;42(3):247-52.