A woman undergoes elective lower segment cesarean section (LSCS) at 39 weeks. The uterine incision is the standard transverse lower uterine segment incision. Compared to the Misgav Ladach (Modified Joel-Cohen) technique, the traditional Pfannenstiel-Kerr technique is associated with:
- A Shorter operative time and less blood loss
- B Greater abdominal wall adhesion formation and longer operating time ✓
- C Lower postoperative pain scores at 24 hours
- D Reduced uterine dehiscence at subsequent delivery
Correct answer: B. Greater abdominal wall adhesion formation and longer operating time
Explanation
The Misgav Ladach (modified Joel-Cohen) technique uses blunt tissue separation, avoidance of unnecessary peritoneal suturing, and manual placental removal, resulting in shorter operative time, reduced blood loss, lower analgesic requirements, and earlier ambulation compared to the traditional Pfannenstiel-Kerr approach. The Pfannenstiel approach with multiple suture layers and peritoneal closure is associated with greater adhesion formation (confirmed in RCTs and observational studies), longer operating time, and increased morbidity at repeat cesarean surgery.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.