Sharp Versus Blunt Uterine Incision Expansion

Study Overview
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Brief Summary
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comparison between blunt versus sharp expansion of uterine incision at lower segment cesarean section in primigravida as regards the intra-operative blood loss & postoperative pain

Detailed Description
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the study includes 200 pregnant women, primigravidas, at term who underwent elective transverse lower segment Cesarean section for the first time among the age group of 20 - 37 years with a singleton pregnancy. The patients are divided randomly into two groups as follows: Group (A): undergoing blunt uterine incision expansion Group (B): undergoing sharp uterine incision expansion

Official Title
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Comparison Between Blunt Versus Sharp Expansion of Uterine Incision at Lower Segment Cesarean Section as Regards the Intra-operative Blood Loss & Postoperative Pain

Conditions
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Cesarean Section Complications

Intervention / Treatment
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* Procedure: blunt uterine incision expansion
* Procedure: sharp uterine incision expansion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: singleton pregnancy. Exclusion Criteria: previous PID any medical or psychiatric patients with BMI ≥ 40 multigravidas chronic analgesia use, allergy to analgesics, multiple pregnancies are also excluded

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 37 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: • Group (A) blunt incision<br>100 primigravidas at term who underwent elective transverse lower segment Cesarean section for the first time among the age group of 20 - 37 years with a singleton pregnancy. undergoing blunt uterine incision expansion | Procedure: blunt uterine incision expansion<br>* blunt uterine incision expansion<br>|
| Active Comparator: • Group (B) sharp incision<br>100 primigravidas, at term who underwent elective transverse lower segment Cesarean section for the first time among the age group of 20 - 37 years with a singleton pregnancy undergoing sharp uterine incision expansion | Procedure: sharp uterine incision expansion<br>* sharp uterine incision expansion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post operative pain | Post-operative pain is analyzed by using 4 point verbal rating scale (VRS) which consists of a list of adjectives describing different levels of pain intensity i.e (no pain =1, mild pain = 2, moderate pain = 3, severe pain = 4) | one hour after cs | 
| intraoperative bleeding | The intra-operative blood loss is evaluated by towels as follows: The surgical towels will be weighed (gm) before and after the operation, and the difference in weight between dry and soaked towels will be calculated. Blood loss during the operation will be calculated by adding the volume of the contents of the suction bottle (ml) to the difference in weight of towels (gm) (weight of soaked towels - weight of dry towels). | from skin incision till skin closure | 
| The operative time is recorded in minutes | The operative time is recorded in minutes | from skin incision till skin closure |