Closure vs Non-Closure of the Visceral and Parietal Peritoneum at Cesarean Delivery: 16 Year Study
Waraporn Weerawetwat MD*, Sayan Buranawanich MD*, Manat Kanawong MD*
Affiliation : * Department of Obstetrics and Gynecology, Paholpolpayuhasena Hospital, Kanchanaburi
Objective : To determine whether non-closure of visceral and parietal peritoneum at LSCS has advantages
over peritoneal closure with regard to postoperative complication and adhesions.
Study
Design : Prospective randomized controlled trial.
Setting : Paholpolpayuhasena Hospital, Kanchanaburi province, Thailand.
Subjects and Method : Three hundred and sixty full-term pregnant women undergoing first cesarean section
were divided into 3 groups (N = 120). Group A: non-closure of both visceral and parietal peritoneum. Group
B: non-closure of only visceral peritoneum. Group C: closure of both visceral and parietal peritoneum.
Postoperative complications were compared. Adhesions were evaluated in 65 patients returning for a second
LSCS and compared for severity of adhesions. The three groups were compared using statistical analysis.
Result : There was no significant statistical difference between group A and C , group B and C for postoperative
complications or number of adhesion formation. However, adhesions in the closure group were more severe.
Conclusions : Closure of visceral and parietal peritoneum has no benefit over non-closure of visceral
peritoneum and non-closure of both visceral and parietal peritoneum at LSCS.
Keywords : Cesarean delivery, Non-closure peritoneum, Adhesion, 16 year study.
