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Extra-peritoneal Caesarean section- our experience

Back ground. On the face of it, Extra-peritoneal procedure might confer advantages over the conventional trans-peritoneal procedure The rationale was simple ; To avoid spillage of frankly infected amniotic fluid into the peritoneal cavity dec

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Extra-peritoneal Caesarean section- our experience

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    1. Extra-peritoneal Caesarean section- our experience

    2. Back ground On the face of it, Extra-peritoneal procedure might confer advantages over the conventional trans-peritoneal procedure The rationale was simple ; To avoid spillage of frankly infected amniotic fluid into the peritoneal cavity decrease the incidence of subsequent abscess and adhesion formation

    3. STUDY to address if EP CS could still play a major role in much of the developing world where obstetric sepsis remains a major challenge. OR extra-peritoneal CS has been rendered obsolete by the advent of antibiotic prophylaxis (Haesslien & Goodlin, 1980)

    4. Objective Comparison of extra-peritoneal versus conventional trans-peritoneal caesarean section To compare the techniques Time taken/blood loss/return of BS pain scores/rapidity of recovery complications rates of infections/need for antibiotics

    5. Subjects Total of 57 patients All primi’s and multi with previous normal delivery Elective or emergency primary CS were included Women with previous LSCS and fetal distress were excluded

    9. RETURN OF BOWEL FUNCTION Bowel sounds appeared at 4hrs in 17% of trans-peritoneal and 27% of EP CS

    10. PAIN documented by Visual analogue scale At 6,12, 24, 48 hrs was high in extra peritoneal group which required additional pain killers

    14. Conclusions from this study Extraperitoneal CS technique almost the Same time to perform (But technically more difficult) same bloodloss /no significant complications

    15. Conclusions (contd) has no great advantage by itself in the present situation with respect to infection control it was in the pre-antibiotic era when it was developed to circumvent the high mortality rate caused by sepsis. Infact patients in this group had more pain and needed additions of medications

    16. Promoting EP CS in rural areas to minimise infection ? Study did not show an advantage on this point. Technique may not be suitable for beginners and emergency situations in rural areas It certainly requires a greater technical expertise

    17. Acknowledgements Thanks to ARTIST- Asian Research & Training Institute for Skill Transfer All patients at Divakars Global Hospital Mr. Ravishankar Vishwanath- Data Analysis Dr Hema Divakar- Concept/Study Design & Guidence.

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