Postcesarean delivery adhesions associated with delayed delivery of infant
Presented in part at the Armed Forces District Annual Meeting of the American College of Obstetricians and Gynecologists, Seattle, WA, Oct. 31-Nov. 4, 2005.
Received 2 May 2006; received in revised form 12 September 2006; accepted 12 December 2006.
Objective
The purpose of this study was to estimate the incidence of adhesions after cesarean deliveries and to determine their impact on delivery and infant well-being.
Study Design
This was a retrospective cohort analysis with chart review. The charts of 542 women who had undergone primary (265 women) or repeat cesarean (277 women) deliveries were reviewed. The incidence, severity, and locations of adhesions; delivery time; cord blood pH, and Apgar scores were noted.
Results
After the first cesarean delivery, 100 of 217 women (46%) had pelvic adhesive disease; 48 of 64 women (75%) who underwent a third cesarean delivery and 5 of 6 women (83%) who underwent a fourth cesarean delivery had formed pelvic adhesive disease. Compared with primary cesarean section, delivery of the infant was delayed 5.6 minutes (52%) with 1 previous cesarean birth, 8.5 minutes (79%) after 2 cesarean birth, and 18.1 (169%) during the fourth cesarean birth (P < 0.001 for all comparisons).
Conclusion
A high percentage of cesarean deliveries result in adhesive disease, which delays repeat cesarean delivery of the fetus. The potential for adhesive disease should be included in counseling regarding primary elective cesarean births.
San Antonio Uniformed Services Health Education Consortium, Wilford Hall Medical Center, Lackland AFB, San Antonio, TX, and Brooke Army Medical Center, Fort Sam Houston, TX.
Reprints: G. Wright Bates, Jr, MD, Atlanta Center for Reproductive Medicine, 100 Stone Forest Dr, Suite 300, Woodstock, GA 30189
Cite this article as: Morales KJ, Gordon MC, Bates GW Jr. Postcesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol 2007;196:461.e1-461.e6.
The opinions expressed in this article are those of the authors and are not meant to be construed as official or as reflecting the opinions of the United States Air Force, the United States Army, or the Department of Defense.
ABSTRACT