Comparison of Misgav-Ladach and Pfannenstiel-Kerr Techniques for Cesarean Section: A Randomized Controlled Trial Study

Cesarean section is one of the most common surgeries around the world. There are several different techniques for cesarean section. The most common techniques are Pfannenstiel-Kerr (PK) and the newer technique Misgav-Ladach (ML). The objective of this trial was to compare intraoperative and short-term postoperative outcomes between the Pfannenstiel-Kerr and the modified Misgav-Ladach techniques in primary cesarean deliveries.

In a prospective controlled trial, 100 females were randomly assigned to the PK (n = 50) and ML (n = 50) groups. The two groups were compared in terms of duration of surgery and fetus delivery, blood transfusion, febrile morbidity, analgesic use, changes of hematocrit level, bowel transition time, wound infection /dehiscence and neonate five-minute Apgar score.

The duration of surgery and fetus delivery was significantly lower in ML than PK technique (P = 0.000). Analgesic use during the post-operative period was significantly lower in ML than PK (P < 0.001). There were no significant statistical differences between the groups in regards to drop of the hematocrit (P = 0.32), fever (P = 0.056) and bowel transit time (P = 1.000). The mean Apgar score of fifth minute was 8.80 ± 0.57 and 9.89 ± 0.42 in PK and ML groups, respectively (P < 0.001).

Misgav-Ladach appears to be faster, requires shorter incision and less analgesic drugs than PK, which might lead to better postoperative outcomes.