Comparing Bet Scissors &Scalpel in Uterotomy in CS

In present-day obstetrics, cesarean delivery occurs in one in three women in the United States, and in up to four of five women in some regions of the world . . Concurrently, despite attempts to encourage vaginal birth after previous cesareans, the cesarean delivery rate increased steadily from 5 to 30-32% over the last 10 years, with a parallel increase in costs as well as short- and long-term maternal, neonatal and childhood complications( 1). Approximately 30% of women will experience a maternal or neonatal complication during childbirth. Both cesarean and vaginal delivery is associated with well-known measurable short- and long-term maternal and neonatal complications and benefits.(2 ) the most concerning complications from cesareans are the neonatal respiratory morbidity and the impact on a mother's future reproductive health, including the risk of abnormal placentation such as placenta previa or accreta.( 3) Fetal laceration injury at cesarean delivery is not rare, especially when it is performed for nonvertex presentation. The minority of obstetric records show documentation of such lacerations, suggesting that this complication often may not be recognized by obstetricians 4. During urgent CS, the surgeon should bear in mind that the presence of PROM or meconium-stained amniotic fluid should prompt extra care and application of preventive measures to decrease blood loss .(.4) To the best of our knowledge, no studies have investigated the association of type of uterotomy and incidence of accidental fetal lacerations. For this reason, in this study we evaluated whether using scissors instead of scalpel in uterotomy can prevent maternal blood loss at time of CS (.5)

Inclusion criteria

• 1.pregnant women age 18-40 years 2.Gestational age between 37-42 weeks 3.Admitted for Elective caesarean delivery in the hospital

Exclusion criteria

• 1.placental pervia and accreta 2.cases refused to be recruited in the study 3. obstructed labor