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.