Incidence of adhesions at repeat cesarean delivery

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, chi(2), 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.