title: Adhesions following cesarean delivery: a review of their occurrence, consequences and preventative management using adhesion barriers.
abstract: The objective of this article is to provide a comprehensive review of the occurrence and consequences of postoperative adhesions following cesarean delivery (CD), and an overview of the published clinical data on prevention in this setting using adhesion barriers. Adhesions occur frequently after CD and the incidence increases with each subsequent CD. Repeat CDs are complicated by adhesions, which increase operating time, time to delivery and risk of bladder injury. Clinical data on the efficacy of adhesion prevention strategies specific to the setting of CD are limited. Two small, nonrandomized studies found that the use of absorbable anti-adhesion barriers was associated with a significant reduction in adhesion formation and a shorter time to delivery at repeat CD, compared with no barrier use. Implications for practice and research are discussed. There is a significant need for well-controlled, randomized clinical studies investigating adhesion prevention in the labor and delivery setting.
authors.affiliation: Queens University of Charlotte, Blair College of Health, Presbyterian School of Nursing, 1900 Selwyn Avenue, Charlotte, NC 28274, USA. poolejh@queens.edu
authors.forename: Judith H
authors.initials: JH
authors.lastname: Poole
mesh_terms: D002483:Cellulose, Oxidized / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control*; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control*; D016387:Women's Health
chemical_list: D002483:Cellulose, Oxidized; C060002:INTERCEED; C118198:Seprafilm; D006820:Hyaluronic Acid