Comparison of Exteriorized With In-Situ Uterine Repair in Caesarean Section Under Spinal Anaesthesia: A Prospective Observational Study

Background Cesarean section is one of the most frequently performed obstetric procedures worldwide. Different surgical techniques have been explored to optimize patient outcomes, among which the method of uterine repair—exteriorized versus in-situ—remains debated. This study compares the effects of exteriorized versus in-situ uterine repair on postoperative nausea, vomiting, pain, patient discomfort, and hemodynamic variables. Methods A total of 60 parturients scheduled for elective cesarean under spinal anesthesia were randomly assigned to two groups: Group A (exteriorized uterine repair) and Group B (in-situ uterine repair). Various intraoperative and postoperative parameters were recorded, including nausea, vomiting, pain (VAS scale), patient discomfort, and requirements of rescue analgesics and antiemetics at designated intervals. Results Exteriorized uterine repair was associated with higher incidences of intraoperative nausea and vomiting, greater postoperative pain, higher need for rescue analgesics and antiemetics, and increased heart rate variability, suggesting significant patient discomfort. In contrast, in-situ uterine repair demonstrated better patient tolerance with lower pain scores and reduced nausea-vomiting episodes. Conclusion This study suggests that in-situ uterine repair is preferable, providing better patient comfort and lower postoperative morbidity. Given the adverse effects observed with exteriorized uterine repair, in-situ repair should be prioritized whenever feasible.