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

  • Maternal-Fetal Medicine
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Abstract

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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany

    Jade Kirscht, Jana Nickol, Sebastian Berlit, Benjamin Tuschy, Benjamin Hoch, Amelie-Verena Trebin, Thomas Große-Steffen, Marc Sütterlin & Sven Kehl

  2. Department of Medical Statistics and Biomathematics, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany

    Christel Weiss

  3. Department of Obstetrics and Gynecology, University Medical Center Erlangen, Erlangen University, Universitätsstr. 21-23, 91054, Erlangen, Germany

    Sven Kehl

Authors
  1. Jade Kirscht
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  2. Christel Weiss
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  3. Jana Nickol
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  4. Sebastian Berlit
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  5. Benjamin Tuschy
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  6. Benjamin Hoch
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  7. Amelie-Verena Trebin
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  8. Thomas Große-Steffen
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  9. Marc Sütterlin
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  10. Sven Kehl
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Corresponding author

Correspondence to Sven Kehl.

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Funding

There was no funding.

Conflict of interest

There are no conflicts of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kirscht, J., Weiss, C., Nickol, J. et al. Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial. Arch Gynecol Obstet 295, 39–43 (2017). https://doi.org/10.1007/s00404-016-4189-4

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  • DOI: https://doi.org/10.1007/s00404-016-4189-4

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