Study on modification of the Misgav Ladach method for cesarean section.

M Li, L Zou, J Zhu
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Abstract

172 cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6 +/- 2.6) min and (5.7 +/- 2.9) min in the Misgav Ladach group (P < 0.05). Median operating time was (28.3 +/- 5.4) min in modification group compared with (27.5 +/- 6.5) min in the Misgav Ladach group (P > 0.05). Average blood loss was (128 +/- 35) ml in modification group compared with (212 +/- 147) ml in the Pfannenstiel group (P < 0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.

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剖腹产 Misgav Ladach 法改良研究。
1999年5月至12月,将172例计划剖宫产的孕妇随机分为改良Misgav Ladach技术的改良组59例、Misgav Ladach技术的Misgav Ladach组57例和Pfannenstiel技术的Pfannenstiel组56例。改良要点包括:横向切开筋膜 2 至 3 厘米,然后钝性分割;不打开和分离内脏腹膜;子宫低位横切口两层缝合;连续缝合皮肤。结果显示,改良组的平均分娩时间为(3.6 +/- 2.6)分钟,Misgav Ladach 组为(5.7 +/- 2.9)分钟(P < 0.05)。改良组的中位手术时间为(28.3 +/- 5.4)分钟,而 Misgav Ladach 组为(27.5 +/- 6.5)分钟(P > 0.05)。改良组的平均失血量为(128 +/- 35)毫升,而 Pfannenstiel 组为(212 +/- 147)毫升(P < 0.05)。结论是改良的 Misgav Ladach 技术不仅保留了 Misgav Ladach 方法的所有优点,还具有其他优点,如胎儿娩出更快、损伤更小、产科医生更容易掌握。
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