Prognosis of Caesarean Section with or Without Externalization of the Uterus at the CHU Ignace Deen, Guinea

<i>Introduction:</i> Caesarean section is an obstetric surgical technique that is becoming more and more frequent, due to the constant quest to improve maternal-fetal health. <i>Objective:</i> The aim of this study was to evaluate maternal prognosis after caesarean section with or without uterine exteriorization during hysterorrhaphy. <i>Patients and Methods:</i> this was a prospective study with analytical aims lasting 6 months from July 1st to December 31, 2022 carried out in the gynecology-obstetrics department of the Ignace Deen national hospital of the CHU of Conakry, focusing on women who underwent cesarean section in the department with or without uterine exteriorization and agreed to participate in the study during the data collection period. <i>Results:</i> the mean age of the patients was 18.62±6.16 years, with extremes of 15 and 44 years. The 21-25 age group was the most represented, at 29.60%. The majority were married (93.68%), not in school (40.07%) and nulliparous (33.75%). Obstetric evacuation was 31.05%. The uterus was exteriorized in 66.6% of cases. Caesarean section was urgent in 79.96% of cases. The average duration of the operation was 34.52±10.47 minutes. The majority of caesarean sections were performed by residents (66.97%). Maternal prognosis was identical in both groups with regard to the following parameters: surgical site infection, thread release, length of hospital stay, postoperative parameters and maternal condition at discharge. On the other hand, intense postoperative pain was significantly associated with non-externalization of the uterus 45.52% versus 23.25% with a p-value=0.00. <i>Conclusion:</i> analysis of these two techniques for surgical closure of the uterus shows very little difference in the occurrence of postoperative complications. Intense pain was influenced by non-externalization of the uterus. This suggests that the choice of repair technique should be left to the obstetrician, pending contrary results from other studies.