The CORONIS trial was a large multinational RCT assessing various aspects of caesarean section technique. Which of the following was a conclusion of CORONIS regarding caesarean technique?
- A Blunt extension of the uterine incision is associated with fewer haemorrhagic complications than sharp extension ✓
- B Closure of the peritoneum reduces long-term adhesion formation
- C Single-layer uterine closure is superior to double-layer in preventing scar rupture
- D Manual extraction of placenta reduces endometritis compared to controlled cord traction
Correct answer: A. Blunt extension of the uterine incision is associated with fewer haemorrhagic complications than sharp extension
Explanation
The CORONIS trial (2013, Lancet) was a fractional factorial RCT of 15,000 women across multiple countries testing five elements of caesarean technique. A key finding was that blunt (digital) extension of the uterine incision significantly reduced haemorrhagic extensions compared to sharp (scissor) extension. Non-closure of the peritoneum was not shown to reduce complications. The trial found no significant difference between single- and double-layer uterine closure in short-term outcomes.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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