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Published on: August 27, 2016
Incidence of adhesions at repeat cesarean delivery
1Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida, USA. khamel@hsc.usf.edu
Objective:
To compare the incidence and severity of adhesions at repeat cesarean delivery based on the closure at primary section.
Study Design:
A retrospective chart review was conducted for 62 cases of repeat cesarean sections. A score was assigned based on the severity of adhesions. The primary operative report was reviewed, and the closure type recorded. Statistical analysis was performed with a t test, chi2, and ANOVA.
Results:
Forty-nine and eight-tenths percent of cases had extensive adhesions. Closure of the peritoneal or rectus abdominis muscle resulted in significantly fewer extensive adhesions than nonclosure (31.2% vs 70.0%; P = .013). The mean adhesion score for the nonclosure group was 2.67, compared with 1.91 for the parietal peritoneal closure group (P = .044) and 1.73 for the rectus muscle group (P = .009), where 1 is no adhesions and 4 is the most severe).
Conclusion:
Closure of the rectus muscle or the parietal peritoneum at primary section resulted in significantly fewer adhesions at repeat cesarean delivery.
