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mercredi 11 août 2010

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

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

Abstract

Objective
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.




Methods
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.




Results
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 ± 2.50, 9.51 ± 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.




Conclusions
Cervical dilatation seems to be an unnecessary intervention during the cesarean section.




  • Content Type Journal Article
  • DOI 10.1007/s00404-010-1608-9
  • Authors

    • Miğraci Tosun, Ondokuz Mayıs University Medical Faculty Department of Obstetrics and Gynecology 55139 Kurupelit, Samsun Turkey
    • Mehmet Sakinci, Ondokuz Mayıs University Medical Faculty Department of Obstetrics and Gynecology 55139 Kurupelit, Samsun Turkey
    • Handan Çelik, Ondokuz Mayıs University Medical Faculty Department of Obstetrics and Gynecology 55139 Kurupelit, Samsun Turkey
    • Burcu Torumtay, Aksaray Şambaz Vehbi Ekecik Maternity Hospital Aksaray Turkey
    • Eren Yazici, Ondokuz Mayıs University Medical Faculty Department of Obstetrics and Gynecology 55139 Kurupelit, Samsun Turkey
    • Tayfun Alper, Ondokuz Mayıs University Medical Faculty Department of Obstetrics and Gynecology 55139 Kurupelit, Samsun Turkey
    • Erdal Malatyalioğlu, Ondokuz Mayıs University Medical Faculty Department of Obstetrics and Gynecology 55139 Kurupelit, Samsun Turkey


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