Adhesion development and morbidity after repeat cesarean delivery

Togas Tulandi; Mohammed Agdi; Afsoon Zarei; Louise Miner; Vanja Sikirica

doi:10.1016/j.ajog.2009.04.039

Adhesion development and morbidity after repeat cesarean delivery

Tulandi T, Agdi M, Zarei A, Miner L, Sikirica V

Published July 2009 American journal of obstetrics and gynecology

DOI 10.1016/j.ajog.2009.04.039 PMID 19576375

Abstract

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; >or= 4 CSs, 10.4 +/- 0.1 minutes; 95% CI, 1-2). However, complication rates in those women with >or= 2 CSs were comparable with primary CS.

Conclusion

Increased adhesion development and a longer time to delivery were found with each subsequent CS.

Togas Tulandi, Mohammed Agdi, Afsoon Zarei, Louise Miner, Vanja Sikirica

T Tulandi, M Agdi, A Zarei, L Miner, V Sikirica

PMID 19576375 19576375 DOI 10.1016/j.ajog.2009.04.039 10.1016/j.ajog.2009.04.039 Tulandi et al. 2009, Tulandi 2009

Adhesion development and morbidity after repeat cesarean delivery

Abstract

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