NONCLOSURE OF THE VISCERAL AND PARIETAL PERITONEUM AT CESAREAN-SECTION - A RANDOMIZED CONTROLLED TRIAL

Objective To assess the short term morbidity of nonclosure of the peri toneum at caesarean section. Design Women undergoing a lower segment c aesarean section were randomly allocated to either closure or nonclosu re of the visceral and parietal peritoneum. Setting Tertiary Care Univ ersity Hospital of Geneva. Main outcome measures Length of post-operat ive hospital stay. Other outcomes include maternal pain as assessed by both a visual analogue scale and the amount of post-operative analges ics administered, post-operative ileus, and febrile morbidity. Operati ve time was recorded. Results We allocated 137 women to the nonclosure group and 143 to the closure group. Population characteristics were s imilar between groups. The mean length of hospital stay was 6.5 (SD 1. 9) days for the nonclosure group and 6.8 (SD 2.2) days for the closure group (P = 0.21). No differences were found in the level of post-oper ative pain, the number of analgesic doses given, nor in the proportion with febrile morbidity. Post-operative ileus resolved later in the cl osure group (P = 0.006). The mean operative time was shorter by 6 min (P = 0.006) in the nonclosure group. Conclusions Short term post-opera tive morbidity and maternal pain are not increased by a shorter and mo re simple surgical procedure in which the peritoneum is left unsutured .