• C Wilkinson and M W Enkin.
• Department of Perinatal Medicine/University Department of Obstetrics & Gynaecology, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, Australia, 5006. cwilkins@medicine.adelaide.edu.au
• Cochrane Db Syst Rev. 2000 Jan 1 (2): CD000085.

BackgroundAfter caesarean delivery of the fetus and placenta, the uterus may be placed outside the mother to facilitate repair of the uterine incision.ObjectivesThe objective of this review was to assess the effects of exteriorisation of the uterus, compared to the effects of uterine closure within the abdominal cavity.Search StrategyWe searched the Cochrane Pregnancy and Childbirth Group trials register.Selection CriteriaRandomised and quasi-randomised trials of uterine exteriorisation for repair compared to intra-abdominal repair for pregnant women undergoing elective or emergency caesarean section.Data Collection And AnalysisTwo reviewers assessed trial quality and extracted the data.Main ResultsTwo trials involving 486 women were included. Neither trial was methodologically strong. Exteriorisation made no significant difference to blood loss. Exteriorisation was associated with fewer post-operative febrile days (fever more than three days, odds ratio 0.40, 95% confidence interval 0.17 to 0.94) and a non-significant trend towards fewer infections. There was also a non-significant trend towards more nausea and vomiting when exteriorisation was done under regional analgesia.Reviewer's ConclusionsThere is not enough information to evaluate the routine use of exteriorisation of the uterus for repair of the uterine incision.

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