Incidence of Adhesions at Repeat Cesarean Delivery

Am J Obstet Gynecol. 2007 May;196(5):e31-2. doi: 10.1016/j.ajog.2006.09.011.


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

Study design: 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).

Conclusion: Closure of the rectus muscle or the parietal peritoneum at primary section resulted in significantly fewer adhesions at repeat cesarean delivery.

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / methods
  • Cesarean Section, Repeat
  • Female
  • Humans
  • Incidence
  • Peritoneum / surgery
  • Pregnancy
  • Rectus Abdominis / surgery
  • Retrospective Studies
  • Tissue Adhesions / epidemiology*
  • Tissue Adhesions / etiology