Incidence of post-operative adhesions following Misgav Ladach caesarean section--a comparative study.
OBJECTIVE
To evaluate the incidence of peritoneal adhesions as a post-operative complication after caesarean section following the Misgav Ladach method and compare it with peritoneal adhesions following traditional caesarean section methods (Pfannenstiel-Dörffler, low midline laparotomy-Dörffler).


METHODS
The analysis is retrospective and is based on medical documentation of the Clinic for Gynecology and Obstetrics, University Clinical Centre, Tuzla, Bosnia and Herzegovina (data from 1 January 2001 to 31 December 2005). We analysed previous caesarean section dependent on caesarean section method (200 by Misgav Ladach method, 100 by Pfannenstiel-Dörffler method and 100 caesarean section by low midline laparotomy-Dörffler). Adhesion scores were assigned using a previously validated scoring system.


RESULTS
We found statistically significant difference (p < 0.05) in incidence of peritoneal adhesions in second and third caesarean section between Misgav Ladach method and the Pfannestiel-Dörffler and low midline laparotomy-Dörffler method. Difference in incidence of peritoneal adhesions between low midline laparotomy-Dörffler and Pfannenstiel-Dörffler method was not statistically different (p > 0.05). The mean pelvic adhesion score was statistically lower in Misgav Ladach group (0.43 +/- 0.79) than the mean score in the Pfannestiel-Dörffler (0.71 +/- 1.27) and low midline laparotomy-Dörffler groups (0.99 +/- 1.49) (p < 0.05).


CONCLUSIONS
Our study showed that Misgav Ladach method of caesarean section makes possible lower incidence of peritoneal adhesions as post-operative complication of previous caesarean section.
Fatusić
Zlatan
Z
Clinic for Gynecology and Obstetrics, University Clinical Centre, Tuzla, Bosnia and Herzegovina.
Hudić
Igor
I
D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D010532:Peritoneal Diseases / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology*