Closure vs Non Closure of Rectus Muscle at Cesarean Section 5 Year Study

Study Overview
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Brief Summary
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approximation of both recti during lower segment cesarean section may be an important step to lower incidence of intraabdominal adhesions . peritoneal adhesions are of major medical importance and are associated with clinical problems such as chronic pain and infertility.

Detailed Description
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all patients included in the study should be had the operative history of the previous cesarean section and were done in the cairo university and divid them into 2 groups. 1st group were both recti approximated while the second group were closed without approximating both recti. all patients will be subjected to lower segment cesarean segment to assess the intraperitoneal adhesions, mean operative time, mean hospital stay, postoperative distension, bowel sounds, postoperative infections and morbidity

Official Title
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Closure vs Non Closure of Rectus Muscle at Cesarean Section Reducing Post Cesarean Adhesions

Conditions
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Intraperitoneal Adhesions After Rectus Muscles Approximation

Intervention / Treatment
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* Procedure: approximation of both rectus muscles


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all patients of first lower segment cs at kasr al ainy with previous recorded data including operative data, postoperative data including complications. all patients included in the study are elective cesarean section at 38 weeks of gestation Exclusion Criteria: no history of infection or medical disease no history of previous laparotomies no history of pregnancy complications patients noted to have intraperitoneal adhesions in first cesarean section

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| approximation of both recti group<br> | Procedure: approximation of both rectus muscles<br>* closure of both rectus muscle before closure of rectus sheeth<br>|
| non approximation of both recti group<br> | Procedure: approximation of both rectus muscles<br>* closure of both rectus muscle before closure of rectus sheeth<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| assessment of the intraperitoneal adhesions post rectus muscle closure | assessment of adhesions bands between the pelvic organs and bowel | intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mean operative time | calculate the mean time for closure of both recti | intraopertive time | 
| mean hospital stay | assess the postoperative time of hospital stay | posoperative within first 48 hrs | 
| mean postoperative bowel sounds | interval between operation and listening the bowel sounds | posoperative within 24 hrs | 
| postoperative distension | assessment of bowel distension postoperative | posoperative within 24 hrs | 
| postoperative morbidity and infections | assess the tempreture, scars | posoperative within 1 week |