Intra-abdominal saline irrigation at cesarean section: A systematic review and meta-analysis

Ahizechukwu Eke, Ghadear Hussein Shukr, Tina Taissir Chaalan, Sereen Khaled Nashif, George Uchenna Eleje

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to examine the evidence guiding intraoperative saline irrigation at cesarean sections.Methods: We searched "cesarean sections", "pregnancy", "saline irrigation" and "randomized clinical trials" in ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, AJOL, MEDLINE, LILACS and CINAHL from inception of each database to April 2015. The primary outcomes were predefined as intraoperative nausea and emesis. The pooled results were reported as relative risk (RR) with 95% confidence interval (95% CI).Results: Three randomized trials including 862 women were analyzed. Intraoperative saline irrigation was associated with a 68% increased risk of developing intraoperative nausea (RR = 1.68, 95% CI 1.36-2.06), 70% increased risk of developing intraoperative emesis (RR = 1.70, 95% CI 1.28-2.25), 92% increased risk of developing post-operative nausea and 84% increased risk of using anti-emetics post-operatively (RR = 1.84, 95% CI 0.21-2.78) when compared with controls. There were no significant differences between intraoperative saline irrigation and no treatment for post-operative emesis (RR = 1.65, 95% CI 0.74-3.67), estimated blood loss, time to return of gastrointestinal function, postpartum endometritis (RR = 0.95, 95% CI 0.64-1.40), urinary tract infection and wound infection.Conclusion: Intraoperative saline irrigation at cesarean delivery increases intraoperative and post-operative nausea, requiring increasing use of anti-emetics without significant reduction in infectious, intraoperative and postpartum complications. Routine abdominal irrigation at cesarean section is not supported by current data.

Original languageEnglish (US)
Pages (from-to)1588-1594
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number10
DOIs
StatePublished - May 18 2016
Externally publishedYes

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Cesarean Section
Meta-Analysis
Confidence Intervals
Nausea
Vomiting
Antiemetics
Postpartum Period
Endometritis
Intraoperative Complications
Wound Infection
Urinary Tract Infections
MEDLINE
Randomized Controlled Trials
Databases
Pregnancy

Keywords

  • Cesarean section
  • meta-analysis
  • saline irrigation
  • systematic review

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Intra-abdominal saline irrigation at cesarean section : A systematic review and meta-analysis. / Eke, Ahizechukwu; Shukr, Ghadear Hussein; Chaalan, Tina Taissir; Nashif, Sereen Khaled; Eleje, George Uchenna.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 29, No. 10, 18.05.2016, p. 1588-1594.

Research output: Contribution to journalArticle

Eke, Ahizechukwu ; Shukr, Ghadear Hussein ; Chaalan, Tina Taissir ; Nashif, Sereen Khaled ; Eleje, George Uchenna. / Intra-abdominal saline irrigation at cesarean section : A systematic review and meta-analysis. In: Journal of Maternal-Fetal and Neonatal Medicine. 2016 ; Vol. 29, No. 10. pp. 1588-1594.
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AU - Nashif, Sereen Khaled

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AB - Objective: The aim of this study was to examine the evidence guiding intraoperative saline irrigation at cesarean sections.Methods: We searched "cesarean sections", "pregnancy", "saline irrigation" and "randomized clinical trials" in ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, AJOL, MEDLINE, LILACS and CINAHL from inception of each database to April 2015. The primary outcomes were predefined as intraoperative nausea and emesis. The pooled results were reported as relative risk (RR) with 95% confidence interval (95% CI).Results: Three randomized trials including 862 women were analyzed. Intraoperative saline irrigation was associated with a 68% increased risk of developing intraoperative nausea (RR = 1.68, 95% CI 1.36-2.06), 70% increased risk of developing intraoperative emesis (RR = 1.70, 95% CI 1.28-2.25), 92% increased risk of developing post-operative nausea and 84% increased risk of using anti-emetics post-operatively (RR = 1.84, 95% CI 0.21-2.78) when compared with controls. There were no significant differences between intraoperative saline irrigation and no treatment for post-operative emesis (RR = 1.65, 95% CI 0.74-3.67), estimated blood loss, time to return of gastrointestinal function, postpartum endometritis (RR = 0.95, 95% CI 0.64-1.40), urinary tract infection and wound infection.Conclusion: Intraoperative saline irrigation at cesarean delivery increases intraoperative and post-operative nausea, requiring increasing use of anti-emetics without significant reduction in infectious, intraoperative and postpartum complications. Routine abdominal irrigation at cesarean section is not supported by current data.

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