The impact of parietal peritoneal closure on postoperative recovery following cesarean section: A prospective observational study

Aim: Caesarean section is one of the most frequently performed surgical procedures in obstetrics.Supporting early functional recovery in the postoperative period is of critical importance for maternalhealth and healthcare efficiency. This study aimed to investigate the short-term effects of parietalperitoneal closure on postoperative recovery following caesarean delivery.Materials and Methods: This prospective observational study included women aged 18–45 years whounderwent elective caesarean section under spinal anesthesia between January 15 and June 15, 2025.Emergency cases, procedures performed under general anesthesia, and high-risk pregnancies wereexcluded. Postoperative recovery was evaluated multidimensionally using the EQ-5D Quality of LifeScale, the Katz Index of Independence in Activities of Daily Living, and the Obstetric Quality of Recovery(ObsQoR) score. Additional outcomes included pain scores, return of gastrointestinal function,requirement for additional analgesics, and hematological parameters (NLR, PLR).Results: A total of 120 women were enrolled, with 60 in the peritoneal closure group and 60 in the nonclosuregroup. On postoperative day 5, EQ-5D scores were significantly higher in the closure group (p < 0.05). No statistically significant differences were observed between groups in terms of pain intensity,gastrointestinal recovery, additional analgesic requirement, or hematological parameters (NLR, PLR).Conclusion: The findings suggest that routine parietal peritoneal closure does not provide additionalbenefits for short-term postoperative recovery when considering early return to daily activities andinflammatory markers. Therefore, the decision to close the peritoneum may be better guided by surgicalpreference and intraoperative conditions rather than routine practice.