Is routine cervical dilatation necessary during elective caesarean section? A randomised controlled trial

Area of Science:

• Obstetrics and Gynecology
• Surgical Procedures
• Maternal Health

Background:

• Elective cesarean sections are common surgical procedures.
• The role of intraoperative cervical dilatation in mitigating maternal morbidity is debated.
• Evidence regarding its impact on blood loss and infection rates is inconclusive.

Purpose of the Study:

• To evaluate the effect of routine intraoperative cervical dilatation during elective cesarean sections on maternal morbidity.
• To assess the impact on postoperative infectious complications and estimated blood loss.

Main Methods:

• Prospective randomized study involving 400 women undergoing elective cesarean section.
• Participants were allocated to either intraoperative cervical dilatation (Group A, n=200) or no dilatation (Group B, n=200).
• Maternal morbidity outcomes including infectious morbidity, endometritis, febrile morbidity, wound infection, and urinary tract infection were compared.

Main Results:

• No significant differences were observed in infectious morbidity, endometritis, febrile morbidity, wound infection, or urinary tract infection between the groups.
• Estimated blood loss was not significantly different between women who underwent cervical dilatation and those who did not.
• Group A experienced significantly longer operative times compared to Group B (P = 0.01).

Conclusions:

• Routine intraoperative digital cervical dilatation during elective cesarean sections does not reduce postoperative infectious morbidity or blood loss.
• The procedure is not recommended for routine use in elective cesarean sections.
• Longer operative times associated with cervical dilatation do not appear to be offset by clinical benefits.