Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial.
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 < 0.001).


CONCLUSIONS
Dilatation of the cervix during cesarean section compared with no dilatation of the cervix did not influence the risk of postpartum hemorrhage. However, there were fewer cases with retained products of conception after dilatation.
['Kirscht|Jade|J|', 'Weiss|Christel|C|', 'Nickol|Jana|J|', 'Berlit|Sebastian|S|', 'Tuschy|Benjamin|B|', 'Hoch|Benjamin|B|', 'Trebin|Amelie-Verena|AV|', 'Große-Steffen|Thomas|T|', 'Sütterlin|Marc|M|', 'Kehl|Sven|S|http://orcid.org/0000-0002-2220-371X']
D000328:Adult D002585:Cesarean Section D004106:Dilatation D005260:Female D006801:Humans D006473:Postpartum Hemorrhage D011247:Pregnancy D011446:Prospective Studies D011644:Puerperal Disorders D016037:Single-Blind Method
Cesarean section Postpartum hemorrhage Infection Retained products of conception Cervical dilatation Postpartum outcome