Comparison of Intra-Operative Hemorrhage by Blunt and Sharp Expansion of Uterine Incision at Caesarean Section
DOI:
https://doi.org/10.51985/Keywords:
Keywords: Caesarean section; Haemorrhage; Hemoglobin; Uterine incision; UterotomyAbstract
Objective: To determine the difference in mean drop in post-operative haemoglobin level after caesarean section with blunt and sharp expansion of uterine incision during the operation.
Study Design and Setting: The study design was a randomized controlled trial, which was carried out at the Department of Obstetrics and gynecology, CMH Rawalakot, between 01- October-2024 and 31-March-2025.
Methodology: 130 women who had elective lower segment caesarean section were recruited and randomly divided into two equal groups: blunt expansion (n=65) and sharp expansion (n=65). Females between 20 and 40 years old with singleton pregnancies of 37 weeks and above with hemoglobin of 10 g/dL and above were included. Haemoglobin was determined before and after the operation (24 hours later). A decrease of more than 1.5 g/dL was regarded as a clinical significance. Analysis of data was done in SPSS version 22; independent-sample t-test was used.
Results: The mean haemoglobin drop in the blunt expansion group (1.37+0.79 g/dL) was significantly less than in the sharp expansion group (1.72+0.85 g/dL; p=0.016). Stratified analysis showed that there were significant differences in favor of blunt expansion in women aged >30 years (p=0.003), gestational age >39 weeks (p=0.008), and parity >2 (p=0.002). Conclusions: Blunt expansion of the uterine incision is related to much less intraoperative blood loss than sharp expansion, which is why it should be used as a safer method of reducing blood loss during a caesarean section, especially in more atrisk subgroups
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Copyright (c) 2026 Summaira Shabbir, Syeda Maryam Batool, Arooj Naseem (Author)
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