Prevalence of intra-abdominal adhesions in patients undergoing repeat cesarean section: An observational retrospective study

Abstract

: To study the prevalence of intraabdominal adhesion in repeat CS and evaluate the maternal and fetal outcome.: CS is a lifesaving procedure for the mother and fetus, but have multiple complications like adhesions, abdominal pain, prolonged duration of surgery, postoperative bleeding, and identification of these can help improve maternal and fetal outcome and care.: This retrospective study reviewed 70 pregnant women undergoing repeat CS. Data was tabulated and analyzed and adhesions were scored based on a system into dense and flimsy, and its dimensions. Chi Square test was used to observe association. P-value<0.05 was taken as significant.: Adhesions were noted in 30(42.9%) of the subjects and 40(57.1%) patients had no adhesions. Dense adhesions were noted in 19(27.1%) and flimsy in 11(15.7%) patients. Among those with adhesions – 6(20%) had atonic postpartum hemorrhage (PPH). No association was noted with fetal outcome. There was a statistically significant increase in duration of surgery in those with adhesions – 126.83 minutes +/- 19.85 than in those without adhesions – 82.35 minutes +/-12.82. Those patients with dense adhesions, the duration of surgery was – 132.63 minutes +/-21.88 and with flimsy adhesions – 116.82 minutes +/-82.: Repeat CS with adhesions increased the duration of surgery, increased the chances of PPH and had no statistically significant effect on neonatal outcome. Furthermore, duration of surgery was prolonged with dense adhesions. Further research can be done including post operative complications, details of prior CS and interpregnancy interval and thereby adhesion prevalence.