TITLE:
The Effect of Omission of the Bladder Flap Formation at Lower Segment Cesarean Delivery: A Randomized Controlled Trial
AUTHORS:
Yasmeen A. Youssef, Tarek A. Farghaly, Elwany Elsenosy, Ahmed A. Youssef, Ahmed M. Abbas
KEYWORDS:
Cesarean Section, Bladder Flap, Hematuria, Lower Segment
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.8,
August
6,
2019
ABSTRACT: Background: This
study aims to evaluate the effects of omission of the bladder flap formation at
primary and repeat lower segment CS. Patients and Methods: The current study was randomized controlled trial conducted in Women
Health Hospital, Assiut University, Egypt between March 2017 and May 2018
(ClinicalTrial.gov NCT03016273). Patients were divided into: Non bladder flap
group: Uterine incision made 1 cm above the vesico-uterine reflection without
incision and dissection of the bladder peritoneum and bladder flap group:
Standard cesarean section technique with incision and dissection of a bladder
flap prior to uterine incision. Results: The
study included 150 patients (75 in each arm). The most common indication for CS
in both groups was repeated CS. Non-bladder flap group, compared with flap group, showed shorter
skin-incision to delivery time and total operative time, and significantly lower mean estimated blood loss and
postoperative pain score. Non-bladder flap group, compared with flap group, was
more likely to show postoperative microhematuria. The two groups required approximately the
same time for post-operative defecation. Conclusion: Omission of bladder flap formation during CS is associated with shorter
operative time, less blood loss, less postoperative pain and lower incidence of
postoperative hematuria.