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As cesarean delivery is the most common major inpatient surgery in the U.S. (with up to 1 million procedures performed annually), the consequences of even small differences in morbidity associated with particular surgical techniques would be magnified across the population. Investigators for the CORONIS study — an international trial in which women undergoing lower-segment cesarean were randomized to various surgical techniques — now report longer-term outcomes.
Of the original 15,633 participants, 13,153 (84%) were followed up at least 3 years after surgery (mean, 3.8 years). Only 44% had subsequent pregnancies during follow-up, substantially lower than expected. In the original study, women were randomized to blunt or sharp abdominal entry…