Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 5/2012

01.11.2012 | Maternal-Fetal Medicine

The Misgav-Ladach method of cesarean section: a step forward in operative technique in obstetrics

verfasst von: Igor Hudić, Emmanuel Bujold, Zlatan Fatušić, Fahrija Skokić, Anela Latifagić, Mirela Kapidžić, Jasenko Fatušić

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

The objective of this study is to compare the intraoperative and short-term outcomes of two cesarean techniques: the modified Misgav-Ladach and the Pfannenstiel–Kerr.

Methods

We performed a prospective observational cohort study of women undergoing a primary cesarean at the Clinic for Obstetric and Gynecology Tuzla, Bosnia and Herzegovina, between January 2003 and December 2011. The two cesarean techniques were compared for intraoperative and short terms outcomes.

Results

A total of 4,944 women were included in this study, 4,336 allocated to the modified Misgav-Ladach and 608 to the Pfannenstiel–Kerr techniques. The rate of modified Misgav-Ladach increased from 74 % in 2003 to 99 % in 2011. The modified Misgav-Ladach technique was associated with a shorter operative time (13.3 min ± 7.4 vs. 19.1 min ± 6.8, p < 0.05), as well as significantly less surgical material (3.5 ± 2.5 vs. 7.9 ± 2.1, p < 0.05). The modified Misgav-Ladach technique was also associated with lower analgesic requirements, lower rates of febrile morbidity and wound infection compared to the Pfannenstiel–Kerr technique (p < 0.05). No significant differences were observed in the incidence of endometritis, wound dehiscence, bowel restitution, postoperative antibiotic use, and hospital stay.

Conclusion

The modified Misgav-Ladach technique is associated with a shorter operative time than Pfannenstiel–Kerr and might lead to better postoperative outcomes.
Literatur
1.
Zurück zum Zitat Chitra K, Gayetri R, Shanthi S (2004) Misgav-Ladach cesarean section vs Pfannenstiel cesarean section. J Obstet Gynecol Ind 54:473–477 Chitra K, Gayetri R, Shanthi S (2004) Misgav-Ladach cesarean section vs Pfannenstiel cesarean section. J Obstet Gynecol Ind 54:473–477
2.
Zurück zum Zitat Xavier P, Ayres-De-Campos D, Reynols A et al (2005) The modified Misgav-Ladach versus the Pfannenstiel technique for cesarean section: a randomized trial. Acta Obstet Gynecol Scand 84:878–882PubMed Xavier P, Ayres-De-Campos D, Reynols A et al (2005) The modified Misgav-Ladach versus the Pfannenstiel technique for cesarean section: a randomized trial. Acta Obstet Gynecol Scand 84:878–882PubMed
3.
Zurück zum Zitat Pfannenstiel J (1897) On the advantages of a transverse cut of the fascia above the symphysis for gynecological laparotomies, and advice on surgical methods and indications. Samml Klin Vortr Gynakol 68:1–22 Pfannenstiel J (1897) On the advantages of a transverse cut of the fascia above the symphysis for gynecological laparotomies, and advice on surgical methods and indications. Samml Klin Vortr Gynakol 68:1–22
4.
Zurück zum Zitat Kerr JMM (1926) The technic of cesarean section with special reference to the lower uterine segment incision. Am J Obstet Gynecol 12:729–734 Kerr JMM (1926) The technic of cesarean section with special reference to the lower uterine segment incision. Am J Obstet Gynecol 12:729–734
5.
Zurück zum Zitat Joel-Cohen S (1972) Abdominal and vaginal hysterectomy. New techniques based on time and motion studies. Heinemann, London Joel-Cohen S (1972) Abdominal and vaginal hysterectomy. New techniques based on time and motion studies. Heinemann, London
6.
Zurück zum Zitat Stark M, Finkel A (1994) Comparison between the Joel-Cohen and Pfannenstiel incision in cesarean section. Eur J Obstet Gynecol Reprod Biol 53:121–122PubMedCrossRef Stark M, Finkel A (1994) Comparison between the Joel-Cohen and Pfannenstiel incision in cesarean section. Eur J Obstet Gynecol Reprod Biol 53:121–122PubMedCrossRef
7.
Zurück zum Zitat Stark M, Chavkin Y, Kupfersztain C et al (1995) Evaluation of combination of procedures in cesarean section. Internat J Gyn Obstet 48:273–276CrossRef Stark M, Chavkin Y, Kupfersztain C et al (1995) Evaluation of combination of procedures in cesarean section. Internat J Gyn Obstet 48:273–276CrossRef
8.
Zurück zum Zitat Irion O, Fournet N (1996) Will you leave the peritoneum open when performing your next caesarean section? Contemp Rev Obstet Gynaecol 8:209–212 Irion O, Fournet N (1996) Will you leave the peritoneum open when performing your next caesarean section? Contemp Rev Obstet Gynaecol 8:209–212
9.
Zurück zum Zitat Hudić I, Fatusić Z, Kamerić L et al (2010) Vaginal delivery after Misgav-Ladach cesarean section—is the risk of uterine rupture acceptable? J Matern Fetal Neonatal Med 23:1156–1159PubMedCrossRef Hudić I, Fatusić Z, Kamerić L et al (2010) Vaginal delivery after Misgav-Ladach cesarean section—is the risk of uterine rupture acceptable? J Matern Fetal Neonatal Med 23:1156–1159PubMedCrossRef
10.
Zurück zum Zitat Fatušić Z, Hudić I, Sinanović O et al (2011) Short-term postnatal quality of life in women with previous Misgav-Ladach caesarean section compared to Pfannenstiel-Dorffler caesarean section method. J Matern Fetal Neonatal Med 24:1138–1142PubMedCrossRef Fatušić Z, Hudić I, Sinanović O et al (2011) Short-term postnatal quality of life in women with previous Misgav-Ladach caesarean section compared to Pfannenstiel-Dorffler caesarean section method. J Matern Fetal Neonatal Med 24:1138–1142PubMedCrossRef
11.
Zurück zum Zitat Shi Z, Ma L, Yang Y et al (2011) Adhesion formation after previous caesarean section-a meta-analysis and systematic review. BJOG 118:410–422PubMedCrossRef Shi Z, Ma L, Yang Y et al (2011) Adhesion formation after previous caesarean section-a meta-analysis and systematic review. BJOG 118:410–422PubMedCrossRef
12.
Zurück zum Zitat Ayres-de-Campos D, Patricio B (2000) Modification to the Misgav-Ladach technique for caesarean section. Acta Obstet Gynecol Scand 79:326–330PubMedCrossRef Ayres-de-Campos D, Patricio B (2000) Modification to the Misgav-Ladach technique for caesarean section. Acta Obstet Gynecol Scand 79:326–330PubMedCrossRef
13.
Zurück zum Zitat Hofmeyr JG, Novikova N, Mathai M, Shah A (2009) Techniques for cesarean section. Am J Obstet Gynecol 201:431–444PubMedCrossRef Hofmeyr JG, Novikova N, Mathai M, Shah A (2009) Techniques for cesarean section. Am J Obstet Gynecol 201:431–444PubMedCrossRef
14.
Zurück zum Zitat Hofmeyr GJ, Mathai M, Shah A, Novikova N (2008) Techniques for caesarean section. Cochrane Database Syst Rev 23(1):CD004662 Hofmeyr GJ, Mathai M, Shah A, Novikova N (2008) Techniques for caesarean section. Cochrane Database Syst Rev 23(1):CD004662
15.
Zurück zum Zitat Kulas T, Habek D, Karsa M, Bobić-Vuković M (2008) Modified Misgav-Ladach method for cesarean section: clinical experience. Gynecol Obstet Invest 65:222–226PubMedCrossRef Kulas T, Habek D, Karsa M, Bobić-Vuković M (2008) Modified Misgav-Ladach method for cesarean section: clinical experience. Gynecol Obstet Invest 65:222–226PubMedCrossRef
16.
Zurück zum Zitat Fatušić Z, Hudić I (2009) Incidence of post-operative adhesions following Misgav-Ladach caesarean section—a comparative study. J Matern Fetal Neonatal Med 22:157–160PubMedCrossRef Fatušić Z, Hudić I (2009) Incidence of post-operative adhesions following Misgav-Ladach caesarean section—a comparative study. J Matern Fetal Neonatal Med 22:157–160PubMedCrossRef
17.
Zurück zum Zitat Mathai M, Hofmeyr GJ (2007) Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev 1:CD004453PubMed Mathai M, Hofmeyr GJ (2007) Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev 1:CD004453PubMed
18.
Zurück zum Zitat Gyamfi C, Juhasz G, Gyamfi P et al (2006) Single- versus double-layer uterine incision closure and uterine rupture. J Matern Fetal Neonatal Med 19:639–643PubMedCrossRef Gyamfi C, Juhasz G, Gyamfi P et al (2006) Single- versus double-layer uterine incision closure and uterine rupture. J Matern Fetal Neonatal Med 19:639–643PubMedCrossRef
19.
Zurück zum Zitat Bujold E, Goyet M, Marcoux S et al (2010) The role of uterine closure in the risk of uterine rupture. Obstet Gynecol 116(1):43–50PubMedCrossRef Bujold E, Goyet M, Marcoux S et al (2010) The role of uterine closure in the risk of uterine rupture. Obstet Gynecol 116(1):43–50PubMedCrossRef
20.
Zurück zum Zitat Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ (2002) The impact of a single-layer or double-layer closure on uterine rupture. Am J Obstet Gynecol 186:1326–1330PubMedCrossRef Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ (2002) The impact of a single-layer or double-layer closure on uterine rupture. Am J Obstet Gynecol 186:1326–1330PubMedCrossRef
21.
Zurück zum Zitat Durnwald C, Mercer B (2003) Uterine rupture, perioperative and perinatal morbidity after single-layer and double-layer closure at cesarean delivery. Am J Obstet Gynecol 189:925–929PubMedCrossRef Durnwald C, Mercer B (2003) Uterine rupture, perioperative and perinatal morbidity after single-layer and double-layer closure at cesarean delivery. Am J Obstet Gynecol 189:925–929PubMedCrossRef
22.
Zurück zum Zitat Jastrow N, Gauthier RJ, Gagnon G et al (2010) Impact of labor at prior cesarean on lower uterine segment thickness in subsequent pregnancy. Am J Obstet Gynecol 202(563):e1–e7PubMed Jastrow N, Gauthier RJ, Gagnon G et al (2010) Impact of labor at prior cesarean on lower uterine segment thickness in subsequent pregnancy. Am J Obstet Gynecol 202(563):e1–e7PubMed
23.
Zurück zum Zitat Roberge S, Chaillet N, Boutin A (2011) Single- versus double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture. Int J Gynaecol Obstet 115:5–10PubMedCrossRef Roberge S, Chaillet N, Boutin A (2011) Single- versus double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture. Int J Gynaecol Obstet 115:5–10PubMedCrossRef
24.
Zurück zum Zitat Nabhan AF (2008) Long-term outcomes of two different surgical techniques for caesarean. Int J Gynaecol Obstet 100:69–75PubMedCrossRef Nabhan AF (2008) Long-term outcomes of two different surgical techniques for caesarean. Int J Gynaecol Obstet 100:69–75PubMedCrossRef
25.
26.
Zurück zum Zitat Malvasi A, Tinelli A, Guido M et al (2010) Should the visceral peritoneum at the bladder flap closed at cesarean sections? A post-partum sonographic and clinical assessment. J Matern Fetal Neonatal Med 23:662–669PubMedCrossRef Malvasi A, Tinelli A, Guido M et al (2010) Should the visceral peritoneum at the bladder flap closed at cesarean sections? A post-partum sonographic and clinical assessment. J Matern Fetal Neonatal Med 23:662–669PubMedCrossRef
27.
Zurück zum Zitat Malvasi A, Tinelli A, Guido M et al (2011) Effect of avoiding bladder flap formation in caesarean section on repeat caesarean delivery. Eur J Obstet Gynecol Reprod Biol 159:300–304PubMedCrossRef Malvasi A, Tinelli A, Guido M et al (2011) Effect of avoiding bladder flap formation in caesarean section on repeat caesarean delivery. Eur J Obstet Gynecol Reprod Biol 159:300–304PubMedCrossRef
28.
Zurück zum Zitat Anderson ER, Gates S (2004) Techniques and materials for closure of the abdominal wall in caesarean section. Cochrane Database Syst Rev CD004663 Anderson ER, Gates S (2004) Techniques and materials for closure of the abdominal wall in caesarean section. Cochrane Database Syst Rev CD004663
29.
Zurück zum Zitat Naumann RW, Hauth JC, Owen J et al (1995) Superficial wound disruption after cesarean delivery: effect of the depth and closure of subcutaneous tissue. Obstet Gynecol 85:412–416PubMedCrossRef Naumann RW, Hauth JC, Owen J et al (1995) Superficial wound disruption after cesarean delivery: effect of the depth and closure of subcutaneous tissue. Obstet Gynecol 85:412–416PubMedCrossRef
30.
Zurück zum Zitat Fatušić Z, Hudić I, Musić A (2011) Misgav-Ladach cesarean section: general consideration. Acta Clin Croat 50:95–99PubMed Fatušić Z, Hudić I, Musić A (2011) Misgav-Ladach cesarean section: general consideration. Acta Clin Croat 50:95–99PubMed
31.
Zurück zum Zitat Tuuli MG, Rampersad RM, Carbone JF et al (2011) Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol 117:682–690PubMedCrossRef Tuuli MG, Rampersad RM, Carbone JF et al (2011) Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol 117:682–690PubMedCrossRef
Metadaten
Titel
The Misgav-Ladach method of cesarean section: a step forward in operative technique in obstetrics
verfasst von
Igor Hudić
Emmanuel Bujold
Zlatan Fatušić
Fahrija Skokić
Anela Latifagić
Mirela Kapidžić
Jasenko Fatušić
Publikationsdatum
01.11.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 5/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2448-6

Weitere Artikel der Ausgabe 5/2012

Archives of Gynecology and Obstetrics 5/2012 Zur Ausgabe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

28.05.2024 Kinder- und Jugendgynäkologie Nachrichten

Welchen Einfluss das Alter ihrer Mutter auf das Risiko hat, dass Kinder mit nicht chromosomal bedingter Malformation zur Welt kommen, hat eine ungarische Studie untersucht. Sie zeigt: Nicht nur fortgeschrittenes Alter ist riskant.

Fehlerkultur in der Medizin – Offenheit zählt!

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.