Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 201, Issue 1, Pages -Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2009.04.039
Keywords
adhesion; cesarean section delivery; delivery time; operating time; repeat cesarean section delivery
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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.
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