Transverse Supraumbilical Versus Pfannenstiel Incision for Cesarean Section in Morbidly Obese Women

Study Overview
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Brief Summary
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This study aims to evaluate the efficacy and safety of transverse supraumbilical incision over Pfannenstiel incision in performing cesarean section for morbid obese pregnant women.

Detailed Description
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Research Question In Morbidly obese women undergoing cesarean section, is transverse supraumbilical incision superior to Pfannenstiel incision? Research Hypothesis Transverse supraumbilical incision is superior to Pfannenstiel incision in morbidly obese women undergoing cesarean section.

Official Title
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Transverse Supraumbilical Versus Pfannenstiel Incision For Cesarean Section in Morbid Obese Patients A Single Blinded Randomized Controlled Trial

Conditions
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Cesarean Section

Intervention / Treatment
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* Procedure: transverse supraumbilical
* Procedure: pfannenstiel incision


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: BMI more than 40 kg/m2 women scheduled for CS Exclusion Criteria: patients receiving steroids or anticoagulation

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: supraumbilical transverse<br>transverse Supraumbilical Incision, in which the skin incision is a straight transverse skin incision slightly higher than the Pfannenstiel (5- 6) cm. from the upper border of the symphysis pubis The high transverse incision facilitated access to the fascia of the rectus abdominalis. Above the panniculus, the fatty tissues are not particularly thick. A transverse opening of the aponeurosis and of the parietal peritoneum was done. Then the approach to the lower uterine segment was easy. A Ricard retractor was put in place. | Procedure: transverse supraumbilical<br>* transverse Supraumbilical Incision, in which the skin incision is a straight transverse skin incision slightly higher than the Pfannenstiel (5- 6) cm. from the upper border of the symphysis pubis The high transverse incision facilitated access to the fascia of the rectus abdominalis<br>|
| Active Comparator: pfannenstiel<br>Pfannenstiel Incision, in which the skin incision is a transverse upward concavity, typically initiated two finger-breadths above the symphysis pubis and extended in the direction of the anterior superior iliac spine below and medial to it about (2 - 3 ) cm. | Procedure: pfannenstiel incision<br>* Pfannenstiel Incision, in which the skin incision is a transverse upward concavity, typically initiated two finger-breadths above the symphysis pubis and extended in the direction of the anterior superior iliac spine below and medial to it about (2 - 3 ) cm.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| occurence of surgical site infection | occurance of redness, hotness, pus discharge and exudation | one week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| operative time in minutes | from skin incision to closure of the skin | 2 hours | 
| blood loss in milliliter | volume of blood during the operation | 2 hours |