Incidence of adhesions at repeat cesarean delivery.
OBJECTIVE
To compare the incidence and severity of adhesions at repeat cesarean delivery based on the closure at primary section.


METHODS
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).


CONCLUSIONS
Closure of the rectus muscle or the parietal peritoneum at primary section resulted in significantly fewer adhesions at repeat cesarean delivery.
Hamel
Kelly J
KJ
Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida, USA. khamel@hsc.usf.edu
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D017604:Cesarean Section, Repeat; D005260:Female; D006801:Humans; D015994:Incidence; D010537:Peritoneum / Q000601:surgery; D011247:Pregnancy; D017568:Rectus Abdominis / Q000601:surgery; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology* / Q000209:etiology