Modified Joel‐Cohen technique for caesarean delivery

Objective To investigate whether a series of changes in the current caesarean section operative routine, based on new knowledge, would be beneficial.Design A prospective controlled trial.Setting Labour ward with approximately 3000 deliveries annually in a suburban area of Gothenburg, Sweden.Participants Seventy‐two pregnant women scheduled for delivery by caesarean section were randomised to either modified Joel‐Cohen technique (n= 36) or Pfannenstiel technique (n= 36).Main outcome measures Blood loss during surgery and operating time.Results based on new knowledge, would be beneficial. The median estimated intra‐operative blood loss was 250 mL in the modified Joel‐Cohen group and 400 mL in the Pfannenstiel group (P= 0.026). The proportion of women with 2 300 mL was 16/36 in the modified Joel‐Cohen group vs 28/36 in the Pfannenstiel group (OR 0.229,95% CI 0.082–0.637). Median operating time was 20 min in the modified Joel‐Cohen group compared with 28 min in the Pfannenstiel group (P < 0.001). The proportion of women with 2 25 min was 1/36 in the modified Joel‐Cohen group vs 33/36 in the Pfannenstiel group (OR 0.003, 95% CI Conclusions We conclude that the modified Joel‐Cohen technique of caesarean delivery reduced intra 0.000–0.026).Conclusions We conclude that the modified Joel‐Cohen technique of caesarean delivery reduced intra‐operative blood loss and operating time compared with the Pfannenstiel technique.