Peritoneal non-closure at caesarean section

C S Wilkinson, M W Enkin
Cochrane Database of Systematic Reviews 2000, (2): CD000163

BACKGROUND: It has been suggested that the peritoneal suture might be omitted during caesarean section without adverse effects.

OBJECTIVES: The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intra-operative and immediate postoperative outcomes.

SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register.

SELECTION CRITERIA: Controlled trials comparing leaving the visceral and/or parietal peritoneum unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section.

DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted by two reviewers.

MAIN RESULTS: Four trials involving 1194 women were included. Non-closure of the peritoneum saved operating time (weighted mean difference of -6.12 minutes, 95% confidence interval -8.00 to -4.27) with no significant differences in postoperative morbidity, analgesic requirements and length of hospital stay. There was a consistent, although nonsignificant, trend for improved immediate postoperative outcome if the peritoneum was not closed.

REVIEWER'S CONCLUSIONS: There seems to be no significant difference in short term morbidity from non-closure of the peritoneum at caesarean section.

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