A randomized controlled study investigating the necessity of routine cervical dilatation during elective cesarean section

Abstract

To investigate if it was necessary to dilate the cervix routinely during elective cesarean section and to determine the effects of this traditional maneuver on maternal morbidity. A total of 150 patients meeting eligibility criteria were enrolled in this prospective, randomized controlled study. Patients were allocated randomly into cervical dilatation group or non-dilated group. In the cervical dilatation group, the surgeon performed cervical dilatation by inserting a double-gloved index finger into the cervical canal of the patients after extraction of placenta and membranes. Endometrial cavity thickness of the patients at postoperative 24 h, development of postoperative febrile-infectious morbidity and postoperative hemoglobin levels were evaluated and compared between the groups. The two groups were comparable with regard to demographic and clinical properties. Mean postoperative endometrial cavity thickness of the dilated group was significantly less than the non-dilated group (6.87 +/- A 2.50, 9.51 +/- A 3.35 respectively, p < 0.0001). The level of hemoglobin reduction was comparable between the groups (p = 0.37). Febrile morbidity was seen in one patient in the dilated group. Endometritis or wound infection was not encountered in either group during the puerperium. Cervical dilatation seems to be an unnecessary intervention during the cesarean section.