DO TRANSVERSE SKIN INCISION & ADHESION AT POST CAESAREAN DELIVERY DELAY DELIVERY OF NEONATES & INCREASE MATERNAL MORBIDITY: A COHORT STUDY

Abstract

Background: The most common major abdominal operation done on women is Caesarean section. Over the past century delivery by Caesarean section has been increased in both developed and developing countries. Various abdominal incisions have been used for Cesarean delivery. Today most of the caesarean section are performed with either a vertical infra umbilical midline incision [VIUI] or pfannenstiel incision. Both the skin incisions possess some benets and drawbacks. Methods: This study was a prospective cohort study conducted in the department of Gynaecology & Obstetrics, Burdwan Medical College & Hospital, Burdwan, West Bengal a tertiary teaching institute, from July, 2017 to November, 2018. 142 mothers were included in the study after informed consent from the patient about being a part of this study. Among them, 37 were with midline vertical skin incision, 51 were with transverse skin incision, and 54 were primigravida. Categorical variables are expressed as Number of patients and percentage of patients and compared across the groups using Pearson's Chi Square test for Independence of Attributes/ Fisher's Exact Test as appropriate. Results: 57.41% of primigravida are in 18 to 20 years age group, 42.59 % in 21-25 years, no women was over 25 years. women with previous vertical incision 27.03% have no adhesion, 59.46 % have mild adhesion, and 13.51% have severe adhesion. In women with previous transverse incision 21.57% have no adhesion, 47.06% have mild adhesion and 31.37%have severe adhesion. 34.7% adhesion are between uterus and bladder, 26.5% adhesion are between uterus and omentum, 20.4% adhesion are between uterus and abdominal wall, 12.2% adhesion between omentum and abdominal wall, 6.2% adhesion are in others organ Conclusions: There was signicant delay in delivery of neonates in post caesarean mothers with previous transverse skin incision than vertical incision. Previous transverse skin incision is associated with more severe adhesion than vertical skin incision