Adhesion development and morbidity after repeat cesarean delivery
Presented at the 57th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists, Chicago, IL, May 2-6, 2009.
Received 27 November 2008; received in revised form 20 April 2009; accepted 22 April 2009.
Objective
The purpose of this study was to evaluate the development and implications of intraabdominal adhesions after repeat cesarean section delivery (CS).
Study Design
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; ≥ 4 CSs, 10.4 ± 0.1 minutes; 95% CI, 1-2). However, complication rates in those women with ≥ 2 CSs were comparable with primary CS.
Conclusion
Increased adhesion development and a longer time to delivery were found with each subsequent CS.
Funded by an educational Grant from Ethicon Inc., Somerville, NJ.
Reprints not available from the authors.
Cite this article as: Tulandi T, Agdi M, Zarei A, et al. Adhesion development and morbidity after repeat cesarean delivery. Am J Obstet Gynecol 2009;201:56.e1-6.
ABSTRACT
Adhesion development and morbidity after repeat cesarean delivery