The Lower Uterine Segment Incision in Conservative Caesarean Section

J. M. Munro Kerr
1921 BJOG: an International Journal of Obstetrics and Gynaecology  
€ 3~ the term " conservative Caesarean section " is meant the non-sterilization of the patient following upon the extraction of the child and the suturing of the uterus. I feel I am voicing the opinion o f all enlightened obstetricians in this and other countries when T say that our dcsire is to perform the conservative operatioa and not to sterilize the patient. W e feel that sterilization of the patient after Caesarean section unless there is some definite disease of uterus, heart, lungs,
more » ... , heart, lungs, etc., or mental weakness, is a crude procedure and will only be justifiable in the future if it is proved beyond doubt that it is not possible to secure a sound uterine cicatrix. If such a decision is forced upon u s it will be most unfortunate, for it will undoubtedly compel us to limit the scope ol Caesarean section and preclude us from extending the operation to many obstetrical complications which we feel could undoubtedly be more suitably dealt with by Caesarean section than by the ordinary methods of treatment at present employed. It is unnecessary to enter into details regarding such conditions, for the indications for Caesarean section were freely considered at the recent meeting of the British Medical Association in Newcastle. The purpose of the present paper is to discuss the relative merits of the ordinary longitudinal incision through the body of the uterus, and the incision through the " lower uterine segment." With this object let us consider the subject under the following heads :-( I ) The evidence that the uterine scar in conservative Caesarean ( 2 ) The reasons why the uterine scar is so frequently defective. (3) The means by which a better scar can be secured with the ordinary longitudinal incision. (1) The lower uterine incision which, in my opinion, is preferable to the ordinary longitudinal incision as 1 believe it gives a sounder cicatrix. section is frequently unsatisfactory. ( I ) T h e evidence that t h e u t e r i n e scar in C m a r e a n section k frequently unsatisfactory. This question has been gone into very fully by Eardley Holland. The results o f his inquiries and inves-
doi:10.1111/j.1471-0528.1921.tb16143.x fatcat:5kcow5dzifgphjby5f7ykeztse