{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:40:26Z","timestamp":1790876426552,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2003,12,22]],"date-time":"2003-12-22T00:00:00Z","timestamp":1072051200000},"content-version":"vor","delay-in-days":630,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2002,4]]},"abstract":"<jats:p><jats:bold>Objective\n\t\t\t\t\t<\/jats:bold> To determine whether the method used to expand the uterine incision for caesarean delivery affects the incidence of intra\u2010operative haemorrhage.<\/jats:p><jats:p><jats:bold>Design\n\t\t\t\t\t<\/jats:bold> A prospective randomised study of women undergoing a low segment transverse caesarean delivery. Participants were assigned to have their uterine incision either sharply or bluntly expanded.<\/jats:p><jats:p><jats:bold>Participants\n\t\t\t\t\t<\/jats:bold> Between June 1998 and June 2000, 470 women drew assignments to the sharp expansion group and 475 to the blunt group.<\/jats:p><jats:p><jats:bold>Results\n\t\t\t\t\t<\/jats:bold> The maternal demographics of age, race, nulliparity, and body mass index as well as pre\u2010operative haematocrit were similar between groups. Compared with the blunt group, the estimated blood loss (886 <jats:italic>versus<\/jats:italic> 843mL, <jats:styled-content><jats:italic>P<\/jats:italic>= 0.001<\/jats:styled-content>), change in the mean haematocrit (6.1%<jats:italic>versus<\/jats:italic> 5.5%, <jats:styled-content><jats:italic>P<\/jats:italic>= 0.003<\/jats:styled-content>), incidence of postpartum haemorrhage (13%<jats:italic>versus<\/jats:italic> 9%; <jats:styled-content>relative risk = 1.23, 95% CI 1.03, 1.46<\/jats:styled-content>) and need for a transfusion (2%<jats:italic>versus<\/jats:italic> 0.4%; <jats:styled-content>relative risk = 1.65, 95% CI 1.25, 2.21<\/jats:styled-content>) were significantly greater in the sharp group.<\/jats:p><jats:p><jats:bold>Conclusion\n\t\t\t\t\t<\/jats:bold> In caesarean delivery, sharply expanding the uterine incision significantly increases intra\u2010operative blood loss and the need for subsequent transfusion.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2002.01296.x","type":"journal-article","created":{"date-parts":[[2003,12,22]],"date-time":"2003-12-22T16:21:54Z","timestamp":1072110114000},"page":"448-452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Intra\u2010operative haemorrhage by blunt versus sharp expansion of the uterine incision at caesarean delivery: a randomised clinical trial"],"prefix":"10.1111","volume":"109","author":[{"given":"Everett F.","family":"Magann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneet P.","family":"Chauhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Bufkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Field","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"James N.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,12,22]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"705","article-title":"Maternal mortality: United States 1982\u20131996","volume":"47","year":"1998","journal-title":"MMWR"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)00677-3"},{"key":"e_1_2_6_4_2","unstructured":"American College of Obstetricians and Gynecologists.Postpartum hemorrhage. Technical Bulletin No. 243. Washington DC :ACOG 1998."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199406000-00004"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)91717-7"},{"key":"e_1_2_6_7_2","first-page":"389","article-title":"Blood loss at time of caesarean section by method of placental removal and exteriorization versus in situ repair of the uterine incision","volume":"177","author":"Magann EF","year":"1993","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_6_8_2","unstructured":"WilkinsonC EnkinMW.Manual removal of placenta at caesarean section. Cochrane Database Systematic Review 2 CD000130 2000."},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90026-4"},{"key":"e_1_2_6_10_2","first-page":"576","volume-title":"Obstetrics: Normal and Problem Pregnancies","author":"Depp R","year":"1996"},{"key":"e_1_2_6_11_2","first-page":"77","article-title":"Factors associated with hemorrhage in caesarean deliveries","volume":"77","author":"Combs CA","year":"1991","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_12_2","first-page":"328","article-title":"Effect of type of anesthesia on blood loss at caesarean section","volume":"69","author":"Gilstrap LC","year":"1987","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(88)90440-1"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.3109\/14767059409017268"},{"key":"e_1_2_6_15_2","first-page":"301","volume-title":"Operative Obstetrics","author":"Clark SL","year":"1995"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90541-1"},{"key":"e_1_2_6_17_2","first-page":"706","volume-title":"Operative Perinatology","author":"Burchell RC","year":"1984"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1471-0528.2002.01296.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1471-0528.2002.01296.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T04:12:51Z","timestamp":1697429571000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/j.1471-0528.2002.01296.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,4]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2002,4]]}},"alternative-id":["10.1111\/j.1471-0528.2002.01296.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1471-0528.2002.01296.x","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,4]]},"assertion":[{"value":"2003-12-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}