Cervical dilatation and curettage in elective caesarean section. A retrospective analysis

Area of Science:

• Obstetrics and Gynecology
• Surgical Outcomes Research

Background:

• Intraoperative cervical dilatation and curettage are sometimes performed during elective Caesarean sections (CS).
• The impact of these procedures on maternal morbidity, specifically postpartum haemorrhage (PPH), requires thorough investigation.

Purpose of the Study:

• To analyze the influence of intraoperative cervical dilatation and curettage during elective Caesarean section (CS) on maternal morbidity.
• To identify risk factors associated with postpartum haemorrhage (PPH) in patients undergoing elective CS.

Main Methods:

• Retrospective evaluation of 1,003 elective Caesarean sections (CS).
• Primary outcome measure: influence of cervical dilatation and curettage on postpartum haemorrhage (PPH).
• Subgroup analyses and multiple logistic regression were used to identify PPH risk factors.

Main Results:

• Multiple pregnancy and high body mass index were identified as significant risk factors for PPH.
• Cervical dilatation and curettage were not statistically significant in reducing PPH.
• Uterine sub-involution was more frequent when the cervix was dilated (p=0.0482).
• Operating time significantly increased with cervical dilatation and/or curettage (p<0.0001).

Conclusions:

• Routine cervical dilatation and/or curettage are not beneficial in elective Caesarean sections (CS).
• Performing these procedures prolongs operating time without improving postoperative outcomes.
• The findings suggest these interventions should not be routinely employed in elective CS procedures.