Archives of Gynecology and Obstetrics

, Volume 297, Issue 5, pp 1075–1077 | Cite as

Considerable observations in cesarean section surgical technique and proposed steps

  • Ahmed Samy El-Agwany
News and Views

Dear Editor,

As with most surgical procedures, there is no standard technique for cesarean delivery [1]. Cesarean delivery is often cited as the most common major surgical procedure performed in an operating room in the United States and more than 55% of deliveries in Egypt are by cesarean section [2]. We have some observations that were noticed during our practice over years regarding cesarean section operative findings and surgical technique. We also proposed some steps to be considered during cesarean section that could be beneficial. We would like to share our observations with colleagues to be evaluated and discussed. One of the common observations encountered during cesarean section was the thinned out (filmy) lower uterine segment (LUS) that was noted in patients with history of previous cesarean section (CS) than those with history of vaginal delivery, with more bleeding and ballooning of the lower segment (atonic LUS) in these cases [3]. We can explain this by poor muscle...


Compliance with ethical standards


This study was not funded.

Conflict of interest

All authors have nothing to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance.


  1. 1.
    Temmerman M (2016) Caesarean section surgical techniques: all equally safe. Lancet 388:8CrossRefPubMedGoogle Scholar
  2. 2.
    Boyle A, Reddy UM, Landy HJ et al (2013) Primary cesarean delivery in the United States. Obstet Gynecol 122:33CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Panda B, Laifer S, Stiller R, Kleinman G (2009) Primary atony of the lower uterine segment as a distinct cause of early postpartum haemorrhage: a case series and management recommendations. J Obstet Gynaecol 29(7):628–632CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Shatby Maternity University Hospital, Department of Obstetrics and Gynecology, Faculty of MedicineAlexandria UniversityAlexandriaEgypt

Personalised recommendations