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Routine cervical dilatation during elective caesarean section. Should we continue?
1Fertility Research/Reproductive Health Unit.
Summary
Routine intraoperative cervical dilatation during elective caesarean sections does not reduce complications. This study found no significant difference in outcomes between women who had cervical dilatation and those who did not.
Area of Science:
- Obstetrics and Gynecology
- Surgical Procedures
- Maternal Health
Background:
- Global increase in caesarean section rates necessitates strategies to mitigate associated complications.
- Intraoperative cervical dilatation is a proposed method to reduce postpartum endometritis and blood loss during caesarean births.
Purpose of the Study:
- To evaluate the effectiveness of intraoperative cervical dilatation in reducing complications during elective caesarean sections.
Main Methods:
- A multicentre, double-blind, randomised controlled trial involving 208 pregnant women in Enugu, Nigeria.
- Participants were randomised into two groups: one with intraoperative cervical dilatation (n=104) and a control group without (n=104).
- Standardised preoperative, intraoperative, and postoperative care was provided, with follow-up to 6 weeks postpartum.
Main Results:
- No statistically significant difference in complications was observed between the group that underwent intraoperative cervical dilatation and the control group.
- Outcomes such as endometritis and postpartum blood loss were comparable between the two study arms.
Conclusions:
- Routine intraoperative cervical dilatation offers no discernible benefit in elective caesarean sections.
- Surgeons should ensure the internal os is clear of placental or fetal membranes before uterine wound closure to prevent complications.
