Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

Özet

OBJECTIVES: There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (cesarean section) with respect to the following inflamma- tory reaction in means of changes in inflammatory marker levels. To evaluate the differences in inflammatory reactions following two different (cesarean section) tech- niques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique. STUDY DESIGN: The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to the Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24 th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24 th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of the study. The differences in inflammatory re- actions between the 0 and 24 th hours were analyzed by calculating the percent change in IL-6 and TNF- α levels, and these percentages were then compared between the groups. RESULTS: There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24 th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001). CONCLUSIONS: The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.