Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 3, March, p. 357–361

doi: 10.17219/acem/66215

Publication type: original article

Language: English

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A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study

Nur Şahin1,A,B,C,D,E,F, Mine Genc1,A,D, Gülüzar Arzu Turan1,B,C, Esin Kasap2,A,B,C, Serkan Güçlü3,D,E,F

1 Department of Obstetrics and Gynecology, Sifa University, Izmir, Turkey

2 Department of Obstetrics and Gynecology, Karatas Hospital, Izmir, Turkey

3 Department of Obstetrics and Gynecology, Kent Hospital, Izmir, Turkey


Background. The modified Misgav-Ladach method (MML) is a minimally invasive cesarean section procedure compared with the classic Pfannenstiel-Kerr (PK) method.
Objectives. The aim of the study was to compare the MML method and the PK method in terms of intraoperative and short-term postoperative outcomes.
Material and Methods. This prospective, randomized controlled trial involved 252 pregnant women scheduled for primary emergency or elective cesarean section between October, 2014 and July, 2015. The primary outcome measures were the duration of surgery, extraction time, Apgar score, blood loss, wound complications, and number of sutures used. Secondary outcome measures were the wound infection, time of bowel restitution, visual analogue scale (VAS) scores at 6 h and 24 h after the operation, limitations in movement, and analgesic requirements. At 6 weeks after surgery, the patients were evaluated regarding late complications.
Results. There was a significant reduction in total operating and extraction time in the MML group (p < 0.001). Limitations in movement were lower at 24 h after the MML operation, and less analgesic was required in the MML group. There was no difference between the 2 groups in terms of febrile morbidity or the duration of hospitalization. At 6 weeks after the operation, no complaints and no additional complications from the surgery were noted.
Conclusion. The MML method is a minimally invasive cesarean section. In the future, as surgeons’ experience increases, MML will likely be chosen more often than the classic PK method.

Key words

cesarean section, postoperative pain, Pfannenstiel incision, modified Misgav-Ladach technique, operating time

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