Abstract
Objective The Misgav-Ladach technique is recommended worldwide to perform cesarean sections
but there is no consensus about the appropriate technique to use in patients with
previous cesarean sections. This study evaluated the feasibility of the Misgav-Ladach
technique in patients with previous cesarean sections.
Study Design This prospective cohort study included all women undergoing cesarean section after
36 weeks of gestation over a 5-month period, with the Misgav-Ladach technique as first
choice, whatever the previous number of cesarean sections.
Results Among the 204 patients included, the Misgav-Ladach technique was successful in 100%,
80%, and 65.6% of patients with no, one, and multiple previous cesarean sections,
respectively. When successful, the Misgav-Ladach technique was associated with a shorter
incision to birth interval in patients with no previous cesarean section compared
with patients with one or multiple previous cesarean sections. Anterior rectus aponeurosis
fibrosis and severe peritoneal adherences were the two main reasons explaining the
Misgav-Ladach technique failure.
Conclusion The Misgav-Ladach technique is possible in over three-fourths of patients with previous
cesarean sections with a slight increase in incision to birth interval compared with
patients without previous cesarean section. Further studies comparing the Misgav-Ladach
and the Pfannenstiel techniques in women with previous cesarean should be done.
Keywords
previous cesarean section - Misgav-Ladach - cesarean technique - incision to birth
interval
