The Effect of Intraabdominal Irrigation at Cesarean Delivery on Maternal Morbidity: A Randomized Trial

Abstract

OBJECTIVE: To determine if intraabdominal irrigation with normal saline at cesarean delivery is associated with increased maternal morbidity. METHODS: One hundred ninety-six women undergoing routine cesarean delivery at at least 37 0/7 weeks' gestation were prospectively randomized to receive 500-1000 mL of normal saline intraabdominal irrigation versus no irrigation after closure of the uterine incision, but before abdominal wall closure. Data were collected for comparison of demographic factors, intrapartum and postpartum complication rates, and maternal and neonatal outcomes. The primary outcome measure was the combined incidence of maternal morbidity, defined as at least one of the following: postoperative infectious morbidity, postpartum hemorrhage, severe anemia, and urinary retention. RESULTS: Ninety-seven patients were randomized to the irrigation group and 99 to the control group. The demographic characteristics of the two groups were similar. Thirteen patients (13.1%) in the control group and 14 patients (14.4%) in the irrigation group experienced maternal morbidity (P= .84). There were no statistically significant differences between the groups in estimated blood loss, operating time, incidence of intrapartum complications, hospital stay, return of gastrointestinal function, incidence of infectious complications, or neonatal outcomes. CONCLUSION: Routine intraabdominal irrigation at cesarean delivery in a low-risk population does not reduce intrapartum or postpartum maternal morbidity. (Obstet Gynecol 2003;101:80-5. © 2003 by The American College of Obstetricians and Gynecologists.)