Routine cervical dilatation during elective cesarean delivery - Is it really necessary?
OBJECTIVE
To examine the necessity of routine cervical dilatation during elective cesarean delivery (ECD).


METHODS
A retrospective cohort study including all ECD during 2005 was performed, comparing post operative complications between patients with and without cervical dilatation.


RESULTS
Out of 666 ECD, 348 underwent routine cervical dilatation. No significant differences were found between the cervical dilatation and the comparison group regarding postpartum febrile morbidity (5.1 and 3.1%, respectively; p = 0.071), hospitalisation duration (4.1 +/- 1.4 and 4.1 +/- 2.0 days; p = 0.95), wound infection (0.9% and 1.25%, p = 0.451) or anemia rate (9.50 +/- 0.73 and 9.54 +/- 0.65, p = 0.91). Nevertheless, among patients following a previous vaginal delivery, cervical dilatation was significantly associated with post-operative fever (OR = 5.8; 95%CI 1.2-38.0; p = 0.021).


CONCLUSIONS
Routine cervical dilatation during ECD does not reduce post operative morbidity. Moreover, among patients with a previous vaginal delivery cervical dilatation is a risk factor for febrile morbidity.
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Arie
A
Koifman
Avi
A
Harlev
Eyal
E
Sheiner
Fernanda
F
Press
Arnon
A
Wiznitzer
D000328:Adult; D002584:Cervix Uteri / Q000601:surgery; D002585:Cesarean Section / Q000379:methods* / Q000534:rehabilitation / Q000706:statistics & numerical data; D015331:Cohort Studies; D004106:Dilatation / Q000379:methods* / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000379:methods* / Q000534:rehabilitation / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D018447:Medical Futility; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies