A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study

Şahin, Neslın; Genç, Mine; Turan, Gülüzar Arzu; Kasap, Esin; Güçlü, Serkan

doi:10.17219/acem/66215

Cited by 5 publications

(20 citation statements)

References 15 publications

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“…This results in earlier ambulation. 14,16,17 Authors observed postoperative nausea, vomiting and fever was significantly less in ML group. Nankali A et al and Adama O et al also observed that use of antibiotics was significantly lower in ML group.…”

Section: Discussionmentioning

confidence: 89%

Evaluation of postoperative outcome of different techniques of lower segment caesarean section

Rajoria

Kala

Hooja

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section. Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared. Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav technique. Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.

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Section: Discussionmentioning

confidence: 89%

Evaluation of postoperative outcome of different techniques of lower segment caesarean section

Rajoria

Kala

Hooja

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…In comparison to MMLM (MD: −62.61 mL, 95% CI: −103.13, −22.09, Tau 2 = 1451.35, I 2 = 92%) (Figure 1B1) and MLM (MD: −125.98 mL, 95% CI: −172.13, −79.83, Tau 2 = 3458.59, I 2 = 87%), PKM had larger estimated blood loss (Figure 1B2). Seven studies reported on changes in hematocrit levels 22,24,27,29,33,37,41 . No differences were found in the change in hematocrit levels for MMLM and PKM (MD: −0.01, 95% CI: −0.08, 0.06, Tau 2 = 0.00, I 2 = 0%) (Figure 1C1).…”

Section: Resultsmentioning

confidence: 96%

“…The total number of patients that underwent CS were 15 251. Of these, 5809 (38.1%) underwent PKM, 10,19–44 3790 (24.9%) MLM, 21,23,25,27,30–32,34–36,38–41,43 and 5597 (36.7%) MMLM 10,19,20,22,24,26,28,29,33,36,42,44 . The range of means for ages of the entire maternal cohort was 23.16–32.33 years and the gestational cohort was 36.50–39.24 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…Operative time was reported in 23 studies 10,19–21,23–33,35–37,39,40,42–44 . MMLM (mean difference [MD]: −11.38 min, 95% confidence interval [CI]: −14.72, −8.04, Tau 2 = 30.56, I 2 = 100%) (Figure 1A1) and MLM (MD: −12.09 min, 95% CI: −14.40, −9.77, Tau 2 = 16.79, I 2 = 97%) had a shorter operative time compared to PKM (Figure 1A2).…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, no change was observed between MLM and PKM in hematocrit levels (MD: 0.06, 95% CI: −0.53, 0.65, Tau 2 = 0.00, I 2 = 0%) (Figure 1C2). Eleven studies reported on changes in hemoglobin levels 10,22,24–30,33,41 . MMLM had less hemoglobin level changes than PKM (MD: −0.19 g/dL, 95% CI: −0.29, −0.08, Tau 2 = 0.01, I 2 = 98%) (Figure 1D1).…”

Section: Resultsmentioning

confidence: 99%

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Misgav‐Ladach or modified Misgav‐Ladach versus Pfannenstiel‐Kerr methods for cesarean deliveries: A systematic review and meta‐analysis

Bourdakos,

Abdulsalam,

Macaron

et al. 2023

Repro Female Child Health

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BackgroundCaesarean sections (CSs) constitute a large proportion of fetal deliveries, yet no consensus exists on optimal surgical method.ObjectivesTo investigate the safety and efficacy of the Pfannenstiel‐Kerr method (PKM) in comparison to Misgav‐Ladach method (MLM) and Modified Misgav‐Ladach method (MMLM) for CS.Search StrategyCochrane, Embase, PubMed, CiNAHL, Scopus, and Web of Science were searched from database inception to March 2023.Selection CriteriaProspective studies comparing MLM with PKM or MMLM with PKM.Data Collection and AnalysisThree authors independently conducted data extraction and assessed quality. Pooled means and proportions were analyzed using inverse variance and Mantel‐Haenszel methods.Main ResultsTwenty‐seven studies with 15 251 patients, met the selection criteria. Both MLM (mean difference [MD]: −12.09 min, 95% confidence interval [CI]: −14.40, −9.77, Tau2 = 16.79, I2 = 97%), (MD: −125.98 mL, 95% CI: −172.13, −79.83, Tau2 = 3458.59, I2 = 87%) and MMLM (MD: −11.38 min, 95% CI: −14.72, −8.04, Tau2 = 30.56, I2 = 100%), (MD: −62.61 mL, 95% CI: −103.13, −22.09, Tau2 = 1451.35, I2 = 92%) demonstrated shorter operative time and decreased blood loss, respectively, compared to PKM. Similarly, both MLM (MD: −1.70 min, 95% CI: −2.26, −1.14, Tau2 = 0.51, I2 = 97%), (MD: −0.77 d, 95% CI: −1.35, −0.19, Tau2 = 0.60, I2 = 98%) and MMLM (MD: −2.80 min, 95% CI: −3.89, −1.70, Tau2 = 1.74, I2 = 100%), (MD: −0.58 d, 95% CI: −1.00, −0.17, Tau2 = 0.29, I2 = 100%) demonstrated shorter fetal extraction time and length of hospital stay, respectively, compared to PKM.ConclusionsMLM and MMLM should be considered safe and effective alternative approaches to CSs.

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French ambulatory cesarean: Mother and newborn safety

Dimassi

Ami

Fauck

et al. 2019

Intl J Gynecology & Obste

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ObjectiveTo evaluate mother and newborn child safety after French ambulatory cesarean (FAUCS).MethodsProspective comparative cohort study in Tunisia (January–June 2018). Pregnant women indicated for primary or repeat cesarean at term underwent FAUCS or Misgav Ladach cesarean (MLC). Surgical outcomes, overall morbidity, and maternal autonomy during recovery were compared.ResultsAmong 112 deliveries, 60 were performed by FAUCS and 52 by MLC. FAUCS was feasible in all cases; surgeons achieved a completely extraperitoneal approach in 39 (65.0%) cases. The main difficulty experienced was fetal extraction. Longer operative procedures were recorded in the FAUCS group; however, women in the FAUCS group reported lower pain scores (3 [2–5] vs 4 [3.7–5], P<0.001) and were more likely to decline analgesics (10 [17.0%] vs 0 [0%], P<0.001). They experienced greater autonomy during recovery (median [interquartile range] time to standing, 2 [1.0–2.5] vs 12.8 [8.9–17.9] hours, P<0.001; time to full meal, 4 [3–6[ vs 26.5 [21–31] hours, P<0.001; effective time to hospital discharge, 1 [1, 2] vs 2 [2, 3] days; P<0.001).ConclusionImplementation of the FAUCS technique was safe and successful, and improved maternal condition after cesarean. These short‐term results need long‐term validation by randomized trials.

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A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study

Abstract: The MML method is a minimally invasive cesarean section. In the future, as surgeons' experience increases, MML will likely be chosen more often than the classic PK method.

Cited by 5 publications

References 15 publications

Evaluation of postoperative outcome of different techniques of lower segment caesarean section

Evaluation of postoperative outcome of different techniques of lower segment caesarean section

Misgav‐Ladach or modified Misgav‐Ladach versus Pfannenstiel‐Kerr methods for cesarean deliveries: A systematic review and meta‐analysis

French ambulatory cesarean: Mother and newborn safety

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