title: Incomplete healing of the uterine incision after cesarean section: is it preventable by intraoperative digital dilatation of the internal cervical ostium?.
abstract: OBJECTIVE
  It was the aim of this study to determine if intraoperative digital dilatation of the closed internal cervical ostium affects the healing of the uterine scar after a cesarean section (CS).
  
  
  METHODS
  In this randomized, prospective study, 94 term pregnant patients who elected to have a CS were assigned to two groups: intraoperative digital dilatation of the internal cervical ostium (group I, n = 48) or no dilatation (group II, n = 46). Vaginal ultrasound was used to check the integrity of the cesarean scar at the uterine incision site 40-42 days after the operation. We calculated the healing ratio based on ultrasonographic results and compared the groups as to the amount of incomplete healing.
  
  
  RESULTS
  The frequency of abnormal scarring was significantly higher in group II (14.3 vs. 40.6%; p < 0.05). The mean healing ratio was significantly higher in group I (0.95 ± 0.12) than in group II (0.87 ± 0.1; p < 0.05). In the multiple logistic regression model, digital dilatation remained the most significant factor affecting abnormal scar formation (odds ratio = 7.7).
  
  
  CONCLUSIONS
  Digital dilatation of a closed cervix in elective CS might lower the incidence of abnormal scarring of the uterine incision.
authors: Suleymaniye Maternity Hospital for Research and Training, Istanbul, Turkey.
authors: Hasan Fehmi
authors: HF
authors: Yazicioglu
authors: Osman
authors: O
authors: Sevket
authors: Murat
authors: M
authors: Ekin
authors: Osman
authors: O
authors: Ozyurt
authors: Mehmet
authors: M
authors: Aygun
mesh_terms: D000328:Adult; D002584:Cervix Uteri; D002585:Cesarean Section / Q000379:methods*; D002921:Cicatrix / Q000000981:diagnostic imaging; D004106:Dilatation / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D014463:Ultrasonography; D014945:Wound Healing / Q000502:physiology*