The impact of mechanical cervical dilatation during elective cesarean section on postpartum scar integrity: a randomized double-blind clinical trial

Figures & data

Figure 1 The study flowchart.

Table 1 The baseline characteristics of the study participants

Variables	Cervical dilatation (n=200)	No cervical dilatation (n=200)	P-value
Age (years)a	29.45±6.58	29.20±6.30	0.727
Paritya	2.60±1.74	2.48±1.61	0.521
Maternal BMI (kg/m^2)a	25.9±4.63	26.3±4.55	0.434
Gestational age (weeks)a	38.18±1.12	38.15±1.11	0.809
No of previous CSb
No CS	75 (37.5)	73 (36.5)	0.668
One CS	82 (41.0)	76 (38.0)
Two CS	27 (13.5)	30 (15.0)
Three or more CS	16 (8.0)	21 (10.5)

Notes:

a Data are presented as mean ± SD and compared using Student’s t-test.

b Data are presented as frequency (percentage) and compared using chi-squared test. Abbreviations: BMI, body mass index; CS, cesarean section.

Table 2 The rate of infectious morbidity in both the study groups after CS

Variables	Cervical dilatation	No cervical dilatation	P-value
Febrile morbiditya	10 (5.0)	21 (10.5)	0.045b
Wound infectiona	11 (5.5)	13 (6.5)	0.717
Endometritisa	3 (1.5)	2 (1.0)	0.227
Uterine subinvolutiona	2 (1.0)	11 (5.5)	0.012b
Duration of hospital stay (days)c	4.17±1.10	4.77±1.17	0.001b

Notes:

a Data are presented as frequency (percentage) and compared using chi-squared test.

b Statistical significant difference.

c Data are presented as mean ± SD and compared using Student’s t-test.

Abbreviation: CS, cesarean section.

Figure 2 Cesarean scar defect by 2D ultrasound.

Figure 3 Residual myometrial tissue assessment by 3D ultrasound in no cervical dilatation group.

Figure 4 RMT assessment by 3D ultrasound in cervical dilatation group.

Abbreviations: CS, cesarean section; RMT, residual myometrial tissue; CX, cervix.

Table 3 The results of ultrasonographic scar assessment in both the study groups 6 months after CS

Variables	Cervical dilatation (n=159)	No cervical dilatation (n=163)	P-value
Scar width (mm)a	23.48±5.70	21.40±3.88	0.002b
Scar depth (mm)a	11.58±0.92	9.88±0.56	0.0001b
Scar distance from internal os (mm)a	9.5±1.7	8.8±1.3	0.0001b
Scar defect (niche)c	8 (5.03)	18 (11.04)	0.048b
Residual MT in niche cases (mm)a	6.5±1.4	4.7±2.3	0.002b
Scar vascularity^c Hyper-vascular Hypo-vascular	56 (35.22) 103 (64.78)	33 (20.25) 130 (79.75)	0.002b

Notes:

a Data are presented as mean ± SD and compared using Student’s t-test.

b Statistical significant difference.

c Data are presented as frequency (percentage) and compared using chi-squared test.

Abbreviations: MT, myometrial thickness; CS, cesarean section.