In Situ or Exteriorized Uterine Repair After Cesarean Delivery: Which Approach Is Better for the Patient?

As cesarean delivery is one of the most common surgical procedures worldwide, obstetric providers seek strategies to decrease morbidity among these patients. Two approaches for closing the uterine incision are in situ repair and closure of an exteriorized uterus. Previous reports hinted at decreased nausea with in situ repair, but definitive data are lacking. Investigators in Montreal conducted a randomized, controlled trial involving 180 women undergoing cesarean birth with spinal anesthesia using standardized spinal medications and blood pressure management. Patients and data collectors were blinded to the repair method. The primary outcome was intraoperative nausea or vomiting after delivery of the infant as graded on a 0–3 scale, with 0…