Adhesion development and morbidity after repeat cesarean delivery.
OBJECTIVE
The purpose of this study was to evaluate the development and implications of intraabdominal adhesions after repeat cesarean section delivery (CS).


METHODS
We reviewed the charts of 1283 women who underwent repeat CS and 203 other women who underwent primary CS. Primary outcome measures were incidence and extent of adhesions, incision-to-delivery interval, and operating time.


RESULTS
No adhesions were found in primary CS. Compared with those women with a second CS (24.4%), significantly more women had adhesions after 3 CSs (42.8%; 95% confidence interval [CI], 0.84-0.99). Compared with a first CS (7.7 +/- 0.3 minutes), the delivery time was significantly longer at subsequent CSs (second CS, 9.4 +/- 0.1 minutes; 95% CI, 1-2; third CS, 10.6 +/- 0.3 minutes; 95% CI, 2-4; >or= 4 CSs, 10.4 +/- 0.1 minutes; 95% CI, 1-2). However, complication rates in those women with >or= 2 CSs were comparable with primary CS.


CONCLUSIONS
Increased adhesion development and a longer time to delivery were found with each subsequent CS.
Tulandi
Togas
T
Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.
Agdi
Mohammed
M
Zarei
Afsoon
A
Miner
Louise
L
Sikirica
Vanja
V
D000005:Abdomen / Q000473:pathology; D000328:Adult; D017604:Cesarean Section, Repeat / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D009017:Morbidity; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology / Q000473:pathology; D014552:Urinary Tract Infections / Q000453:epidemiology