The relevance of post-cesarean adhesions

With an increasing number of cesareans and repeat cesarean deliveries, clinicians have started to realize the importance of adhesions after cesarean delivery. Adhesions develop more frequently and with increasing severity with each repeat cesarean, and are associated with increasing maternal morbidity especially bladder injury and increased delivery time. It appears that adhesion formation could be reduced with closure of the peritoneum, double-layer closure of the uterine incision, and the use of adhesion barrier. In many reports of adhesion formation after cesarean delivery, authors have used different methods to evaluate adhesions. We encourage clinicians to adopt a newly published site-specific classification of adhesions after caesarean delivery.