The effect of peritoneal cavity saline irrigation at cesarean delivery on maternal morbidity and gastrointestinal system outcomes

Abstract

Objective: The objective of this study is to investigate the effect of peritoneal cavity saline irrigation during cesarean section (CS) on gastrointestinal disturbance and postoperative infectious morbidity (PIM).

Methods: This prospective randomized clinic trial included 430 women who underwent elective or primary CS. The participants were randomized to either an irrigation of the abdominal cavity or the control group. The primary outcome measured was the rate of antiemetic drugs required in the postoperative period following CS. Secondary outcome measures included the rate of PIM.

Results: Participants in both groups had similar demographic and clinical characteristics. The rate of antiemetic drugs required by patients was significantly higher in the irrigation group when compared with the control group (15.8% versus 8.4%, p = 0.018). The rate of intraoperative nausea and emesis (p ≤ 0.001) and the rate of postoperative nausea and emesis (p ≤ 0.001 and p = 0.018, respectively) were significantly higher in the irrigation group compared with the control group.

Conclusions: Irrigation with saline at the time of CS increases both intraoperative and postoperative nausea and emesis without any beneficial effects on PIM. Routine use of saline irrigation in the abdominal cavity does not seem to be reasonable.

Keywords:

• Cesarean
• emesis
• irrigation
• nausea

Acknowledgements

We gratefully acknowledge the investigators, coinvestigators, study coordinators, and the patients who participated in this trial.

Declaration of interest

The authors report that they have no conflicts of interest. This work was supported by departmental funds only.