title: Postoperative adhesion development following cesarean and open intra-abdominal gynecological operations: a review.
abstract: In this review, we discuss the pathophysiology of adhesion development, the impact of physiological changes associated with pregnancy on markers of adhesion development, and the clinical implications of adhesion development following cesarean delivery (CD). Although peritoneal adhesions develop after the overwhelming majority of intra-abdominal and pelvic surgery, there is evidence in the literature that suggests that patients having CD may develop adhesions less frequently. However, adhesions continue to be a concern after CD, and are likely significant, albeit on average less than after gynecological operations, but with potential to cause significant delay in the delivery of the baby with serious, lifelong consequences. Appreciation of the pathophysiology of adhesion development described herein should allow a more informed approach to the rapidly evolving field of intra-abdominal adhesions and should serve as a reference for an evidence-based approach to consideration for the prevention and treatment of adhesions.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
authors.forename: Awoniyi O
authors.initials: AO
authors.lastname: Awonuga
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Fletcher
authors.forename: Ghassan M
authors.initials: GM
authors.lastname: Saed
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010532:Peritoneal Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D000267:Tissue Adhesions; D016896:Treatment Outcome