Pelosi-type vs. traditional cesarean delivery - A prospective comparison

OBJECTIVE: To determine the effect of a simplified method of cesarean deliv ery on postoperative febrile morbidity, operative time, blood loss, total c ost and length of hospital stay at Yale New Haven Hospital. STUDY DESIGN: From March 22, 1997, until September 26, 1997, 304 consecutiv e primary low transverse cesarean deliveries were evaluated at Yale New Hav en Hospital. The patient age, duration of ruptured membranes, use of prophy lactic antibiotics, operative rimes, blood loss, major complications, analg esic use, diet advancement, length of hospital stay and total cost of hospi talization were recorded for 275 eligible cases. RESULTS: The Pelosi technique was employed in 101 cases, while 174 were per formed with Yale's traditional methods. Both groups were comparable regardi ng demographic characteristics. Two women in the Pelosi group (1.98%) devel oped postoperative fevers as compared with 17 (9.77%) in the traditional gr oup (relative risk, 4.93; confidence interval, 1.16, 20.91; P=0.5). The mea n operating time was 27 minutes in the Pelosi group versus 45 minutes in th e traditional group (P=.01). The mean casts were $7,623.55 in the experimen tal group versus $8,613.28 in the controls (P=.001). No significant differe nces were seen between the use of prophylactic antibiotics, duration of mem brane rupture, analgesic use or hospital stay between the two groups. No se rious maternal or fetal outcomes occured in either group. CONCLUSION: Pelosi-type cesarean delivery resulted in significantly decreas ed operative time, blood loss and overall cost and improved patient outcome over traditional cesarean section.