Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial

• Published in: Archives of gynecology and obstetrics 2017, Vol.295 (1), p.39-43
• Main Authors: Kirscht, Jade, Weiss, Christel, Nickol, Jana, Berlit, Sebastian, Tuschy, Benjamin, Hoch, Benjamin, Trebin, Amelie-Verena, Große-Steffen, Thomas, Sütterlin, Marc, Kehl, Sven
• Format: Article
• Language: English
• Subjects: Adult; Cesarean section; Cesarean Section - adverse effects; Cesarean Section - methods; Clinical trials; Dilatation - adverse effects; Endocrinology; Female; Gynecology; Health risk assessment; Human Genetics; Humans; Maternal-Fetal Medicine; Medicine; Medicine & Public Health; Morbidity; Obstetrics/Perinatology/Midwifery; Postpartum Hemorrhage - etiology; Pregnancy; Prospective Studies; Puerperal Disorders - etiology; Single-Blind Method; Urinary tract infections
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-016-4189-4

Purpose To assess the effects of mechanical dilatation of the cervix during cesarean section on postoperative morbidity. Methods A total of 447 women with elective cesarean section were included in the Dondi trial (Dilatation or no dilatation of the cervix during cesarean section). The primary outcome measure of this randomized controlled trial was postpartum hemorrhage (PPH) within 6 weeks. Infectious morbidity (puerperal fever, endometritis, wound infection, and urinary tract infection), blood loss (need for blood transfusion or change in hemoglobin levels), and operating time were also evaluated. Results The rate of PPH within 6 weeks was not different between the two groups [dilatation group: 5 (2.4 %), no dilatation group: 3 (1.2 %), p  = 0.479]. Infectious morbidity, blood loss, and operating time were not diverse as well. The only significant difference between the two groups was the rate of retained products of conception with fewer cases after cervical dilatation (0 versus 6.2 %, p