Randomized study of nonclosure or closure of the peritoneum at cesarean delivery in 123 women: The impact of the interval to the next pregnancy

CESAREAN DELIVERY IN 123 WOMEN: THE IMPACT OF THE INTERVAL TO THE NEXT PREGNANCY YOSHIKO KOMOTO, SHIMOYA KOICHIRO, SHIMIZU TAKASHI, SON MIHYON, KINUGASA YUKIKO, TSUBOUCHI HIROAKI, HAYASHI SHUSAKU, MARI TOMIIE, FUKUDA HIROTSUGU, WASADA KENSHI, MURATA YUJI, Osaka University, Obstetrics and Gynecology, Suita, Osaka, Japan, Shimizu womens’ clinic, Takarazuka, Japan, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan OBJECTIVE: Cesarean delivery is the most common intraperitoneal surgical procedure. Nonclosure of the peritoneum at cesarean delivery has attained widespread use. We conducted this study to evaluate the effect of nonclosure of peritoneum at cesarean delivery on the interval to the next pregnancy. STUDY DESIGN: Between 1995 and 2000, 123 women who were to undergo cesarean delivery were randomized to one of two categories after informed consent. Group assignment was based on the last digit of the patient’s medical record. 123 women scheduled for low transverse cervical cesarean were randomized to either closure of both the visceral and parietal peritoneum with absorbable suture (N = 70) or no both peritoneal closure (N = 53). RESULTS: There was no significant difference between the groups in characteristics, such as maternal age, parity, gestational age, maternal body weight, and neonatal weight. There was significant difference in the average operating time (closure group; 41.7G6.9 min.; nonclosure group; 35.3G5.9 min.; p!0.001) and the number of analgesic doses after operation (closure group; 2.4G1.1; nonclosure group; 2.0G0.9; p!0.05). There was no significant difference in the incidence of febrile morbidity, urinary tract infection and cystitis, endometritis, wound problems, pneumonia, ileus, anemia, and number of patients receiving therapeutic antibiotics. The time interval from cesarean section to the next pregnancy in the nonclosure group was significantly shorter than that in the closure group. CONCLUSION: We conclude that nonclosure of visceral and parietal peritoneum at cesarean delivery appears to have no adverse effect on immediate postoperative recovery, decrease the number of analgesic doses and shorten operating time and may be more likely to desire to achieve a next pregnancy.