title: Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effects of mechanical dilatation of the cervix during cesarean section on postoperative morbidity.
  
  
  METHODS
  A total of 447 women with elective cesarean section were included in the Dondi trial (Dilatation or no dilatation of the cervix during cesarean section). The primary outcome measure of this randomized controlled trial was postpartum hemorrhage (PPH) within 6 weeks. Infectious morbidity (puerperal fever, endometritis, wound infection, and urinary tract infection), blood loss (need for blood transfusion or change in hemoglobin levels), and operating time were also evaluated.
  
  
  RESULTS
  The rate of PPH within 6 weeks was not different between the two groups [dilatation group: 5 (2.4 %), no dilatation group: 3 (1.2 %), p = 0.479]. Infectious morbidity, blood loss, and operating time were not diverse as well. The only significant difference between the two groups was the rate of retained products of conception with fewer cases after cervical dilatation (0 versus 6.2 %, p < 0.001).
  
  
  CONCLUSIONS
  Dilatation of the cervix during cesarean section compared with no dilatation of the cervix did not influence the risk of postpartum hemorrhage. However, there were fewer cases with retained products of conception after dilatation.
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Jade
authors: J
authors: Kirscht
authors: Department of Medical Statistics and Biomathematics, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Christel
authors: C
authors: Weiss
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Jana
authors: J
authors: Nickol
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Sebastian
authors: S
authors: Berlit
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Benjamin
authors: B
authors: Tuschy
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Benjamin
authors: B
authors: Hoch
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Amelie-Verena
authors: AV
authors: Trebin
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Thomas
authors: T
authors: Große-Steffen
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
authors: Marc
authors: M
authors: Sütterlin
authors: Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany. sven.kehl@gmail.com.|Department of Obstetrics and Gynecology, University Medical Center Erlangen, Erlangen University, Universitätsstr. 21-23, 91054, Erlangen, Germany. sven.kehl@gmail.com.
authors: Sven
authors: http://orcid.org/0000-0002-2220-371X
authors: S
authors: Kehl
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D004106:Dilatation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000209:etiology; D016037:Single-Blind Method
keywords: Cervical dilatation; Cesarean section; Infection; Postpartum hemorrhage; Postpartum outcome; Retained products of conception