Do Different Cesarean Surgery Techniques Make a Difference?

By Eva Martin, MD of Elm Tree Medical, Inc.

A c-section is a c-section is a c-section. Right? Nope. There are a variety of techniques that vary from one surgeon to the next. Most patients do not realize that there are options in the ways to execute certain maneuvers, but there are quite a few for this common surgery. While each obstetrician has her favorite technique, do these variations actually make a difference in outcomes for patients? Thanks to the CORONIS trial, we now have a look into 5 different techniques.

The CORONIS trial enrolled almost 16,000 women to receive one of two variations of 5 interventions during their cesarean deliveries. The women hailed from all over the globe: Argentina, Chile, Ghana, India, Kenya, Pakistan, and Sudan. The investigators followed 84% of these women for 3 years after the delivery to learn about long term effects and effects on subsequent pregnancies. Below is a quick reference of their findings, in one easy table.

*Other studies have shown an increased risk of uterine dehiscence (scar coming open) in subsequent pregnancies with single layer uterine closure.

The findings provide us with the first comprehensive, randomized peek into variations in cesarean surgical techniques, but we still need a lot more research. Most of the participating hospitals were large research centers, which may not reflect the average community hospital. The women enrolled also had a relatively low rate of subsequent pregnancy, limiting the study's ability to measure outcomes for future pregnancies. Nevertheless, the findings do support surgeon's individual choice in techniques.

We want to hear from you! How did you decide which surgical techniques you favor during cesarean delivery?