Hysterotomy

[1] This surgical incision is used in several medical procedures, including during termination of pregnancy in the second trimester (or abortion) and delivering the fetus during caesarean section.

There is an increased risk of this complication occurring due to trauma from previous procedures utilizing hysterotomies, such as caesarean section and dilation, though the mechanism is unknown.

[5][3] A hysterotomy is used to remove a fetus from the uterus, similar to a procedure known as caesarean section, in order to terminate a pregnancy in the second trimester of later.

Dilation and curettage refers to the opening or widening of the cervix and scooping and scraping the tissues that are inside of the uterus.

[7] Although fetal delivery through caesarean section is a very common surgery done in the world, it comes with several risks including bleeding, infection, thromboembolism, and soft-tissue injury.

[8] Gestational age, newborn birth weight, and danger presenting risks are all taken into account on whether or not a classic hysterotomy or low transverse incision will be made.

[9] A resuscitative hysterotomy is performed during or near the occurrence of a cardiac arrest, in which an incision is made to remove the fetus from the uterus.

[12] Hysterotomy is a technique used during fetal surgery to access the fetus in the pregnant uterus in order to treat a birth defect such as spina bifida.

[13] A standard hysterotomy remains the gold-standard for the closure of a fetal spina bifida because it is the safest and most effective when compared to mini-hysterectomies and a percutaneous two-layer fetoscopy.

Both types of uterine positioning for repair yielded similar lengths of hospital stay, risk of infection, and estimated blood loss.

[3] Caesarean sections require a large incision of the uterus, which can lead to complications such as blood loss, postoperative pain, anaemia due to continuing blood loss, fever and possible wound infection, breastfeeding issues, difficulty passing urine, future fertility problems, and/or possible complications in future pregnancies including uterine rupture.

Since the lower uterine segment is not yet fully developed during a preterm labor, these two incisions are preferred in order to provide adequate space for manipulations during delivery of the fetus.

A low transverse incision would not provide adequate space and could entrap the fetal head therefore risking intercranial hemorrhage, morbidity and mortality for the fetus.

Other professionals will say the blunt expansion allows for reduced risk of hemorrhaging or excessive bleeding and improves healing for the patient.

[3] A hysterotomy is completed by closing the uterus either by using a stapler or by suture, no significant differences have been noted to show one technique takes precedent over another.