Routine Cervical Dilatation at Cesarean Section and Its Influence on Pain Scores and Post-Operative Morbidity: A Randomized Controlled Study

Abstract

Objective: We hypothesized that, collection of blood in the intrauterine cavity and distended uterus in women after elective caesarean section could lead to increasing pain. The aim of this study was to identify the effect of routine cervical dilation during elective caesarean section on infectious morbidity, postpartum hemorrhage, and pain after labor by using visual analogue scale (VAS). Methods:A case-control study was conducted on 245 pregnant women who had elective cesarean section at Bakırköy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul. The cases had intraoperative digital cervical dilatation at elective cesarean section while the controls did not.Results: There was a significant reduction in hemoglobin levels postoperatively in each group (p=0.001 for both groups), but the level of reduction was not statistically different between the groups (p = 0.37). The duration of operation was not statistically different between the two groups. In addition, there were no statistically significant difference in febrile morbidity (p =0.478), endometritis (p = 0.311), wound infection (p = 0.297) and UTI (p =0.479). Mean postoperative endometrial cavity thickness of the dilated group was significantly less than that of the non-dilated group (7.8 ± 4.1, 6.8 ± 3.8, respectively, p=0.044). We found VAS scores of dilated group to be significantly less than those of the non-dilated group (5.4 ± 3.0, 4.6 ± 2.8, respectively, p=0.023)