Caesarean section: In good surgical skills we trust

摘要

No fewer than 18-5 million caesarean sections are undertaken annually worldwide,1 making up 9-33% of all births in Africa, Latin America, and Asia.2"4 In The Lancet, the CORONIS Collaborative Group5 present a well thought out randomised controlled trial that included 15935 women from 19 sites in Argentina, Chile, Ghana, India, Kenya, Pakistan, and Sudan, and that assessed the effects of five elements of the caesarean section surgical procedure on short-term outcomes. The comparisons undertaken in the CORONIS trial were as follows: (1) blunt versus sharp abdominal entry; (2) exterior versus intraabdominal repair of the uterus; (3) single-layer versus double-layer closure of the uterus; (4) closure versus non-closure of the pelvic and parietal peritoneum; and (5) chromic catgut versus polyglactin-910 for uterine repair. No statistically significant differences were noted in the primary outcome, which was a composite of death, maternal infectious morbidity, further operative procedures, or blood transfusion of more than 1 unit of whole blood or packed cells up to the 6-week follow-up visit