Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, 68167 Mannheim, Germany.
In Vivo. 2013 Sep-Oct;27(5):661-5.
BACKGROUND/AIM: To analyze the influence of intraoperative cervical dilatation and curettage during elective Caesarean section (CS) on maternal morbidity.
A total of 1,003 elective CS were retrospectively evaluated. Primary outcome measure was the influence of cervical dilatation and curettage on postpartum haemorrhage (PPH). Several subgroup analyses were performed and a multiple logistic regression model was used in order to identify risk factors affecting PPH.
Multiple pregnancy (p=0.0025) and body mass index (p=0.0251) were identified as risk factors for PPH. Curettage, cervical dilatation, prior CS, age, and duration of pregnancy were statistically not significant at a level of α=0.10. There was a significantly higher proportion of women suffering from uterine sub-involution when the cervix was dilated (p=0.0482). The operating time was significantly longer when curettage and/or dilatation were performed (p<0.0001).
Routine cervical dilatation and/or curettage in elective Caesarean section are not beneficial. Accomplishment of either or both of these measures led to a prolonged operating time, without improving the postoperative outcome.
背景/目的：分析择期剖宫产术中行宫颈扩张和刮宫术对产妇发病率的影响。
回顾性评估了 1003 例择期剖宫产术。主要观察指标为宫颈扩张和刮宫术对产后出血（PPH）的影响。进行了几项亚组分析，并使用多因素逻辑回归模型来确定影响 PPH 的危险因素。
多胎妊娠（p=0.0025）和体重指数（p=0.0251）是 PPH 的危险因素。刮宫、宫颈扩张、既往剖宫产、年龄和妊娠时间在α=0.10 水平上无统计学意义。当宫颈扩张时，子宫复旧不良的妇女比例明显更高（p=0.0482）。当进行刮宫和/或扩张时，手术时间明显延长（p<0.0001）。
择期剖宫产术中常规行宫颈扩张和/或刮宫术并无益处。进行这些措施中的任何一项或两项都会导致手术时间延长，而不会改善术后结果。
