engleski

The Misgav Ladach method--a step forward in operative technique in obstetrics

Aim: To investigate the advantage of performing cesarean section using the MisgavLadach method and to justify its use in everyday practice. Methods: In a prospective study we analyzed over a two year period (200001) cesarean sections carried out using the MisgavLadach method at our clinic. We compared both 550 cases of MisgavLadach (ML) and 100 cases of Pfannenstiel (PH) cesarean section. In the group that had undergone the MisgavLadach method we sutured the uterus in one layer and left the peritoneum nonsutured, and in the group who had undergone Pfennenstiel we sutured the uterus in two layers and also sutured the visceral and parietal peritoneum. In every case we analyzed: maternal age, gestational age, duration of operation, consumption of suture material, duration of hospitalization, and surgical complications. Results: Incidence of postoperative febrile morbidity was 5.45%, in the MisgavLadach group compared with 13.2% in the Pfannenstiel group (p < 0.05). Local infection of the wound in the MisgavLadach group was found in 4.54% and in the Pfannenstiel group in 9% (p < 0.05). Mean time of extraction of the newborn in the MisgavLadach group was 1.25 minutes, and in the Pfannenstiel group 4.10 minutes (P<0.05). Mean duration of operation in the MisgavLadach group was 10.98 min, and in the Pfannenstiel group 25 min (p < 0.05). Mean duration of hospitalization in the MisgavLadach group was 4.75 days, and in the Pfannenstiel group 6.32 days (p > 0.05). Mean consumption of suture material in the group MisgavLadach was 3.10 sutures per operation, and in the Pfannenstiel group was 9.5 sutures. Conclusion: Our study shows that the MisgavLadach method of cesarean section enables fast recovery and shorter hospitalization, and reduces the length of the operation, the incidence of surgical complication and the consumption of surgical materials.

cesarean section; gynecological surgery; joel-cohen cut; peritoneum closure

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