Digital Cervical and Cesarean Section

Study Overview
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Brief Summary
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Cesarean delivery is one of the most commonly performed surgical operations worldwide Cesarean delivery even as an elective procedure has been associated with considerable maternal risks compared with vaginal delivery. Some of the complications include postpartum hemorrhage, uterine infection, urinary tract infection, wound infection, septicemia and maternal death. Over the years, many variations in the surgical technique of Cesarean delivery have been employed with the main purpose of improving its safety. A woman's cervix is firm and undilated at the beginning of pregnancy, but progressive remodeling occurs during gestation until the cervix is soft at term, especially the nulliparous cervix . The progressive dilatation of the cervix needs uterine contraction during labor. A mechanical dilatation of the cervix at cesarean section is defined as an artificial dilatation of the cervix performed by finger, sponge forceps or other instruments at non-labor cesarean section. According to a cochrane view The information currently available about the advantages of cervical dilatation at cesarean section is inconclusive. This may be due to small sample sizes and low power of statistic.

Official Title
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The Role of Digital Cervical Opening in Elective Cesarean Section

Conditions
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Caesarean Section

Intervention / Treatment
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* Procedure: Caesarean section
* Other: cervical dilatation
* Other: No cervical dilatation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All women scheduled for elective cesarean section will be approached. Women accepted to participate in the study participation after discussing the nature of the study. Exclusion Criteria: Immuno-compromised women. Women suffering from any coagulation disorder or Blood disease. Blood transfusion during surgery or before it. History of wound infection or endometritis . Ante partum hemorrhage. History of long corticosteroid use. Women refuse to participate in the study. Suspected clinical evidence of infection. anemic women Multiple pregnancy Preterm births Rupture of membranes or chorioamnionitis Women who use antibiotics during the last 24 hours due to any infection but not prophylactic antibiotic during caesarian section Emergency caesarean section

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group A: cervical dilatation<br>patients who will have cervical dilatation during Caesarean section | Procedure: Caesarean section<br>* Caesarean section will be done to deliver the baby<br>Other: cervical dilatation<br>* Cervical dilatation will be done by double gloves digital dilatation postpartum<br>|
| Group A: non cervical dilatation<br>patients who will have not cervical dilatation during Caesarean section | Procedure: Caesarean section<br>* Caesarean section will be done to deliver the baby<br>Other: No cervical dilatation<br>* after delivery of the baby cervix will be remain closed<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The amount of postpartum blood loss (ml) |  | 24 hours |