Is routine cervical dilatation necessary during elective caesarean section? A randomised controlled trial.
OBJECTIVE
The purpose of this prospective randomised study was to determine the effect of routine cervical dilatation during elective caesarean section on maternal morbidity.


METHODS
Participants with indication for elective caesarean section were randomly allocated to two groups. Group A (n = 200) women with intraoperative cervical dilatation; group B (n = 200) women with no intraoperative cervical dilatation.


RESULTS
No demographic differences were observed between groups. There was no significant difference between groups in infectious morbidity (P = 0.87) (relative risk (RR) 1.11, 95% confidence interval (CI) 0.58-2.11), endometritis (P = 0.72) (RR 1.68, 95% CI 0.39-7.14), febrile morbidity (P = 0.66) (RR 1.21, 95% CI 0.51-2.87), wound infection (P = 0.82) (RR 1.11, 95% CI 0.44-2.81), endometritis (P = 0.72) (RR 1.68, 95% CI 0.39-7.14) or urinary tract infection (P = 1.00) (RR 1.00, 95% CI 0.28-3.50), and estimated blood loss (P = 0.2). However, group A had longer operative times compared with the group B (P = 0.01).


CONCLUSIONS
Intraoperative digital cervical dilatation during elective caesarean section did not reduce blood loss and postoperative infectious morbidity. The routine digital cervical dilatation during elective caesarean section is not recommended.
Güngördük
Kemal
K
Department of Obstetrics and Gynecology, Istanbul Bakirkoy Women and Children Hospital, Istanbul, Turkey. maidenkemal@yahoo.com
Yildirim
Gokhan
G
Ark
Cemal
C
D000328:Adult; D019072:Antibiotic Prophylaxis; D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods*; D004106:Dilatation / Q000009:adverse effects; D017558:Elective Surgical Procedures; D004716:Endometritis / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D011247:Pregnancy; D012306:Risk; D055815:Young Adult