Abstract
Aim: To determine the effect of routine intraoperative cervical dilatation during elective cesarean section on maternal morbidity.
Subjects and methods: Patients with even numbers in the operative elective cesarean section list were included in the study. Of these, every second patient underwent intraoperative cervical dilatation. All participants in the two groups had otherwise similar preoperative care, operative procedures and subsequent clinical care. Blood loss was estimated and maternal infection status was assessed postoperatively by any rise of temperature or wound infection.
Results: Of the 131 patients included in the study, 67 underwent cervical dilation and 64 served as controls. There was no significant difference in postoperative hemoglobin, incidence of fever, or wound infection between the two groups. Only two of the cervical dilation group and one control patient developed postoperative fever. A hemoglobin drop of more than 0.5 g/dL was noted in 27 and 26 patients in the cervical dilation and the no dilation groups, respectively (NS). None of the study patients had signs of wound infection.
Conclusion: Intraoperative cervical dilatation during elective cesarean section did not reduce the risk of postoperative maternal fever, wound infection or change in hemoglobin concentration.
References
1 Bollapragada SS, LC Edozien: Apparent absence of lochia after elective Caesarean section. J Obstet Gynaecol22 (2002) 558Search in Google Scholar
2 Dickinson JE: Caesarean section. In: James DK, PJ Steer, CP Weiner, B Gonik (eds): High Risk Pregnancy, Management Options. WB Saunders, London 1999, pp 1223Search in Google Scholar
3 Donald I: Practical Obstetric Problems. Lloyd-Luke, London 1979, pp 847Search in Google Scholar
4 Duff P: Pathophysiology and management of post-cesarean endomyometritis. Obstet Gynecol67 (1986) 26910.1097/00006250-198602000-00021Search in Google Scholar PubMed
5 Galaal KA, A Krolikowsaki: A randomized controlled study of peritoneal closure at caesarean section. Saudi Med J21 (2002) 759Search in Google Scholar
6 Hofmeyr GJ: Caesarean section. In: Chamberlain G (ed): Turnbull's Obstetrics. Churchill Livingstone, Edinburgh 1995, pp 726Search in Google Scholar
7 Hojberg KE, J Aagaard, H Laursen, L Diab, NJ Secher: Closure versus non-closure of peritoneum at Cesarean section – evaluation of pain. Acta Obstet Gynecol Scand77 (1998) 741Search in Google Scholar
8 Hopkins L, F Smaill: Antibiotic prophylaxis regimens and drugs for Caesarean section. Cochrane Database Syst Rev 2000; CD00113610.1002/14651858.CD001136Search in Google Scholar PubMed
9 Johanson RB. Obstetric procedures. In: Edmonds DK (ed): Dewhurst's Textbook of Obstetrics and Gynaecology for Postgraduates. Oxford, Blackwell Science 1999, pp 318Search in Google Scholar
10 Myerscough PR: Munro Kerr's Operative Obstetrics. London, Bailliere-Tindall 1982, pp 302Search in Google Scholar
11 Nagele F, H Karas, D Spitzer, A Staudach, S Karasegh, A Beck, et al.: Closure or non-closure of the visceral peritoneum at cesarean delivery. Am J Obstet Gynecol174 (1996) 1366Search in Google Scholar
12 Pietrantoni M, MT Parsons, WF O'Brien, E Collins, RA Knuppel, WN Spellacy: Peritoneal closure or non-closure at cesarean. Obstet Gynecol77 (1991) 293Search in Google Scholar
©2005 by Walter de Gruyter Berlin New York