Supravesical Transverse Cesarean Section, A Safer and Easier Approach

Abstract

Objective to recommend supravesical transverse cesarean section (STCS), a safe method of cesarean section with transverse uterine incision at about 1.5 centimeters superior to the vesico-uterine fold without dissection of the urinary bladder and to compare it with the conventional low transverse cesarean section (LTCS).

Main outcome measures Major complication related to the uterine incision, time from incision to delivery of the baby, length of hospital stay, evidence of adhesion and/or impending uterine rupture at subsequent repeated STCS's.

Results There was significantly less major complication from STCS (0 out of 283 cases) compare to LTCS (7 out of 477 cases with three cases of cesarean hysterectomy for uncontrollable bleeding). Significantly less time to delivery the baby, shorter hospital stay and no evidence of increase adhesions or impending uterine rupture in repeated STCS.

Conclusion By eliminating the dissection and pushing down of the urinary bladder, The supravesical transverse cesarean section is less traumatic, easier to perform with fewer short term and no increased long term complications.