Routine Cervical Dilatation at the Non-labour Caesarean Section and Its Influence on Postoperative Pain
Condition: Post Operative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Caesarean section is a common method of delivery in obstetrics. With the recent increase in
      the rate of this procedure, it is wise to understand and implement the optimal surgical
      technique. Therefore, different operational methods have been defined to reduce the risk of
      peri/post-operative morbidity.

      The digital dilatation of cervix during elective caesarean section has still been a concern
      when evaluating this issue. This procedure is supposed to help the drainage of blood and
      lochia postpartum, thus reducing infection or the risk of postpartum haemorrhage (PPH).
      However, on the contrary, this mechanical manipulation may also result in contamination by a
      vaginal micro-organism and increase the risk of infections or cervical trauma. Additionally,
      the effect of routine cervical dilatation on patients' perception of pain has not been
      studied sufficiently yet. As a result, the current literature lacks evidence of cervical
      dilatation on postoperative pain and is even not all in agreement regarding the potential
      benefits on overall maternal morbidity.
    

Detailed description: 
      Caesarean section is a common method of delivery in obstetrics. With the recent increase in
      the rate of this procedure, it is wise to understand and implement the optimal surgical
      technique. Therefore, different operational methods have been defined to reduce the risk of
      peri/post-operative morbidity.

      The digital dilatation of cervix during elective caesarean section has still been a concern
      when evaluating this issue. This procedure is supposed to help the drainage of blood and
      lochia postpartum, thus reducing infection or the risk of postpartum haemorrhage (PPH).
      However, on the contrary, this mechanical manipulation may also result in contamination by a
      vaginal micro-organism and increase the risk of infections or cervical trauma. Additionally,
      the effect of routine cervical dilatation on patients' perception of pain has not been
      studied sufficiently yet. As a result, the current literature lacks evidence of cervical
      dilatation on postoperative pain and is even not all in agreement regarding the potential
      benefits on overall maternal morbidity.

      In this prospective study, our primary aim is to evaluate the effect of intra-operative
      digital dilatation of cervix on post-operative pain. We hypothesize that dilatation of the
      cervix as compared with non-dilatation will result in less pain by reducing fluid and blood
      stasis inside the uterine cavity. Our secondary objective is to assess the maternal morbidity
      including a reduction in haemoglobin concentrations, puerperal fever, puerperal endometritis
      and wound infection.
    

Intervention name(s): Cervical dilation
Intervention type(s): Procedure
Intervention description(s): manual dilatation of the cervix using surgeon's finger.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Prevention