Patient description: The patient is a 35-year-old woman with myasthenia gravis, class IIa. She complains of diplopia and fatigue and weakness that affects mainly her upper limbs. She had a positive anti-AChR antibody test, and her single fiber electromyography (SFEMG) was positive. She takes pyridostigmine 60 mg three times a day. But she still has some symptoms that interfere with her job. She is a research coordinator and has 3 children. Her 70-year-old father has hypertension. She does not smoke or use illicit drugs. She drinks alcohol occasionally at social events. Her physical exam and lab studies were not remarkable for any other abnormalities. BP: 110/75 Hgb: 11 g/dl WBC: 8000 /mm3 Plt: 300000 /ml Creatinine: 0.5 mg/dl BUN: 10 mg/dl Beta hcg: negative for pregnancy

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Pregnancy Related Cesarean Wound Disruption Cesarean Section; Infection Pregnant female age great than 18 years 2. Singleton gestation 3. Plan for cesarean delivery 4. Planned gestational age of at least weeks at the time of delivery 5. English speaking 6. Able to provide own informed consent 7. Intention of being available for entire study period and complete all relevant study procedures, including follow-up study visits and phone calls  at screening/enrollment: 1. Diabetes requiring therapy (type I or type II diabetes, gestational diabetes on medical therapy) 2. BMI greater than or equal to 40 kg/m2 at the time of enrollment 3. Placenta previa or placenta accreta 4. Prior bowel or urologic surgery (except un-ruptured appendectomy or uncomplicated cholecystectomy) 5. Multiple gestation 6. Previous history of postpartum hemorrhage requiring medical or surgical treatment 7. Known or suspected impairment of immunologic function including infection with HIV, hepatitis B or C 8. Known tobacco or drug use 9. Any condition which, in the opinion of the investigator, may pose a health risk to the subject or interfere with the evaluation of the study objectives 10. History of keloid formation at time of surgery: 1. Labor at time of presentation to labor and delivery (regular, painful uterine contractions occurring every 5 minutes with evidence of cervical change) 2. Chorioamnionitis or other systemic infection at time of presentation for cesarean section, including evidence of lower abdominal skin infection (i.e. yeast, etc) 3. Need for urgent Cesarean section (examples but not limited to: non-reassuring fetal status (category II or III tracing), placental abruption, severe preeclampsia or eclampsia) 4. Rupture of membranes prior to the start of the surgery 5. Meconium-stained or blood-stained amniotic fluid 6. Experiences intraoperative hemorrhage requiring transfusion, disseminated-intravascular coagulopathy (DIC), or other medical or surgical condition during the delivery deemed by the investigator to pose a prohibitively high risk for surgical re-exploration or wound complication. 7. Who, in the investigator's opinion, would have any clinically significant condition that would impair the patient's ability to comply with the study procedures 8. Need for vertical skin incision 9. Intraoperative use of hemostatic agent (examples and 10. Plan for use of staples at closure of the skin incision 11. Preeclampsia with severe features