Background: Cesarean section is the combination of laparotomy followed by hysterotomy. Nowadays, a lower abdominal transverse incision is used for most cesarean sections, with the Pfannenstiel incision being the classic method described in 1900. This study aims to evaluate the operative, postoperative, and neonatal outcomes of the Pfannenstiel incision compared to the Modified Joel-Cohen incision.

Materials and Methods: This institution-based, prospective, comparative study was conducted from January 2023 to March 2024 at Medical College, Kolkata. A total of 192 patients undergoing their first cesarean section were divided into two groups of 96 each (Pfannenstiel and Modified Joel-Cohen). Parameters such as operative time, blood loss, postoperative pain, analgesia requirements, and neonatal APGAR scores were compared.

Results: The Modified Joel-Cohen incision significantly reduced operating and delivery times compared to the Pfannenstiel group. Postoperative pain and the number of days requiring analgesics were also significantly lower in the Joel-Cohen group. There were no statistically significant differences in intraoperative blood loss or neonatal outcomes between the two groups.