It came from a randomized clinical test with two arms which took place over two months from 1st September to 30 October 2015. The obstetrics and gynecology department of the regional hospital of Banfora served us as framework study. This department employs 2obstetricians’ doctors, 28 midwives, 10 nursesspecialized in anesthetists, 13 nurses specialized in surgery. The regional hospital coverage area includes an urban area and a rural part for a total population of about 1,200,000 persons.

Were included in our study all patients who underwent a caesarean on a pregnancy age greater than 28 weeks gestation, during the study period. Were excluded from our sample, cesareans for eclampsia, sickle cell SS, SC, fetal death, lost sight of patients, as well as those in which consent was not obtained. After consent, the randomization was to simple random sampling without replacement of the study group in the ratio of 2/3 in favor of Misgav-Ladach’s technique.

We used an individual record of data collection informing on epidemiological, clinical, therapeutic and prognostic of patients. The admission records, clinical records, prenatal consultation booklets, the operative report records, anesthesia records resuscitation, records bandages and postoperative follow-up were also exploited. The data were entered into computer and analyzed using EpiData and SPSS. Data collected in intraoperative and postoperative in both groups were compared. Statistical tests of Student and Khi2 were used to compare the respective average and proportions. The significance level adopted was 5%.

The visual analog scale (VAS) was the reference tool. Pain considered low for VAS lower to 3 did not receive support. The one considered moderate by a VAS between 3 and 6 was supported by analgesics level 1, orally. The one considered strong by VAS greater than 6 were supported by painkillers level 2, parenterally.

The blood loss was indirectly assessed by the calculated difference in hemoglobin between the before and after cesarean 24 hours. This change in hemoglobin was an indirect assessment of blood loss.

All patients benefited from bolus antibiotic, ceftriaxone during the cesarean and with amoxicillin after the cesarean.

In our series, we found an average timing of 28.27 minutes for the conventional technique and 27.98 minutes for Misgav-Ladach’s with a non-significant p-value

p = 0.001.

of 0.49. We cannot conclude that the practice of Misgav-Ladach is faster than the conventional. This could be explained by the fact that most young practitioners do not respect more rigorously all the time described for conventional, the closing time of the parietal and visceral peritoneum were dropped. The influence of the non-closure of the visceral peritoneum on operative time was analyzed by Nagele [17] . From a randomized study it showed that the non-closure of the peritoneum allows a considerable reduction in operative time (56.9 minutes versus 50.6 minutes with p < 0.001).

The average duration of Misgav-Ladach in our series is lower than that reported by Moreira, 36 minutes [16] and greater than that of 20.4 mm reported respectively by Studzinski [18] and Ansaloni [19] . The differences noted between the series could be explained by the number of years of practical experience. Several studies comparing the Misgav-Ladach and the conventional have found a reduction in the operating time with Misgav-Ladach [13] [15] [18] [19] [20] [21] . Reducing the chirurgical intervention times described in Misgav-Ladach may be explained by several factors [18] [19] [21] :

・ the speed of the incision of Joel Cohen,

・ the non-separation of segmental pre peritoneum allows uterus faster opening,

・ non closure of visceral peritoneum and the parietal peritoneum,

・ closure of the fascia with a running suture,

・ skin closure without reconciliation subcutaneous tissue with only 4 to 5 points of Blair Donati.

During the conventional caesarean 6 tissue layers are closed while in the cesarean of Misgav-Ladach only three layers are sutured (Uterus, fascia, skin), so explaining the timeliness of this latest.

In our series, we found a mean change in hemoglobin concentration of 1.69 g/dl for the conventional versus 1.37 g/dl for Misgav-Ladach with a value of p = 0.6 insignificant. Our series using an indirect assessment reports no difference in blood loss using the technique. Other authors like Dar J [22] and Studzinski [18] by direct quantification of blood loss, showed that the Misgav-Ladach is less bleeding than the conventional. This difference in blood loss between the two techniques, could be explained by the fact that in the Misgav-Ladach’s different layers of the wall are stretched and not severed and that the vessels are not harmed reducing the risk of major bleeding.

In our series, the average number of threads of suture used was 2.84 and 2.27 for CC for MLC with a value of P = 0.007, significant. We can conclude that the MLC uses less thread than the CC. Our results are similar to those of Koné A [14] reported a mean number of 2.5 and Moreira [16] which reported a number of 2.92. The gain of thread with MLC may be explained by the difference in the number of layers to be sutured in both types of cesarean (CC: 6; MLC: 3).

In our series the mean healing time was 16.33 days to 21.97 days for MLC versus the CC with a value of p = 0.001, significant. The healing time of the MLC is shorter than that of the CC. This is easily understood since the MLC, one avoids tearing the tissue, the spacing being the golden rule.

In our series, we recorded a suppurating rates in parietal CC18.18% against 6.06% in MLC with a value of p = 0.046, significant. The CC is a more provider of suppuration than the MLC. This difference can be explained by the type of suture. Extra-running sutures dermal and intradermal are source of inflammatory response by their presences in situ until it they are resolved.