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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Routine cervical dilatation during elective cesarean delivery - Is it really necessary?
Arie Koifman1, Avi Harlev, Eyal Sheiner
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Summary
Routine cervical dilatation during elective cesarean delivery (ECD) is not necessary. It does not reduce postpartum complications and may increase fever risk in women with prior vaginal births.
Area of Science:
- Obstetrics and Gynecology
- Surgical Procedures
- Maternal Health
Background:
- Elective cesarean delivery (ECD) is a common surgical procedure.
- The necessity of routine cervical dilatation during ECD remains debated.
- Understanding potential complications is crucial for optimizing obstetric care.
Purpose of the Study:
- To evaluate the clinical necessity of routine cervical dilatation in elective cesarean delivery.
- To compare postoperative complications between patients who underwent cervical dilatation and those who did not.
Main Methods:
- Retrospective cohort study design.
- Inclusion of all elective cesarean deliveries performed in 2005.
- Comparison of postoperative complications, including febrile morbidity, hospitalization duration, wound infection, and anemia rates.
Main Results:
- No significant differences in overall postoperative complications were observed between groups.
- Postpartum febrile morbidity: 5.1% with dilatation vs. 3.1% without (p=0.071).
- Among patients with a previous vaginal delivery, cervical dilatation was linked to a higher risk of postoperative fever (OR=5.8, p=0.021).
Conclusions:
- Routine cervical dilatation during elective cesarean delivery does not decrease postoperative morbidity.
- Cervical dilatation in women with a history of vaginal delivery is identified as a risk factor for febrile morbidity.
