title: Cervical dilatation and curettage in elective caesarean section. A retrospective analysis.
abstract: OBJECTIVE
  To analyze the influence of intraoperative cervical dilatation and curettage during elective Caesarean section (CS) on maternal morbidity.
  
  
  METHODS
  A total of 1,003 elective CS were retrospectively evaluated. Primary outcome measure was the influence of cervical dilatation and curettage on postpartum haemorrhage (PPH). Several subgroup analyses were performed and a multiple logistic regression model was used in order to identify risk factors affecting PPH.
  
  
  RESULTS
  Multiple pregnancy (p=0.0025) and body mass index (p=0.0251) were identified as risk factors for PPH. Curettage, cervical dilatation, prior CS, age, and duration of pregnancy were statistically not significant at a level of α=0.10. There was a significantly higher proportion of women suffering from uterine sub-involution when the cervix was dilated (p=0.0482). The operating time was significantly longer when curettage and/or dilatation were performed (p<0.0001).
  
  
  CONCLUSIONS
  Routine cervical dilatation and/or curettage in elective Caesarean section are not beneficial. Accomplishment of either or both of these measures led to a prolonged operating time, without improving the postoperative outcome.
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, 68167 Mannheim, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Berlit
authors.forename: Jana
authors.initials: J
authors.lastname: Nickol
authors.forename: Christel
authors.initials: C
authors.lastname: Weiss
authors.forename: Benjamin
authors.initials: B
authors.lastname: Tuschy
authors.forename: Jade
authors.initials: J
authors.lastname: Mayer
authors.forename: Marc
authors.initials: M
authors.lastname: Sütterlin
authors.forename: Sven
authors.initials: S
authors.lastname: Kehl
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D004107:Dilatation and Curettage / Q000009:adverse effects; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000517:prevention & control; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Caesarean section; cervical dilatation; curettage; infection; postpartum haemorrhage; postpartum outcome