Keywords
intraperitoneal adhesion
scar
abdominal sagging
How to Cite
Abstract
Objective: Similar to other intra-abdominal operations, previous cesarean section (CS) is associated with intra-peritoneal adhesion (IPA) formation which can cause complications and morbidity during repeat CS. IPA and scar formation are related to the individual healing process. The aim of this study is to find out if previous cesarean scar characteristics could predict the presence and degree of IPA at repeat cesarean delivery.
Materials and Methods: Previous CS incision scar characteristics (length, width, pigmentation, and morphology) and the lower abdominal sag of pregnant women meeting the study criteria were evaluated before the operation. During the repeat CS, IPA presence and severity were evaluated and scored according to the clinical adhesion scoring system.
Results: IPA severity was significantly related to the previous scar width and degree of abdominal sagging.
Conclusions: Evaluation of scar characteristics and abdominal sag before laparotomy could help the surgeon to predict the presence and severity of IPA and to prepare preoperatively for possible complications.
References
(1) Ananth CV, Friedman AM, Keyes KM, Lavery JA, Hamilton A, Wright JD. Primary and Repeat Cesarean Deliveries. Epidemiology. 2017; 28: 567-574
(2) Declercq E, Barger M, Cabral HJ, Evans SR, Kotelchuck M, Simon C, et al. Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births. Obstet Gynecol. 2007; 109: 669-677
(3) Placek PJ, Taffel SM. Trends in cesarean section rates for the United States, 1970-78. Public Health Rep. 1980; 95: 540-548.
(4) Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Matthews TJ. Births: Final Data for 2014. Natl Vital Stat Rep. 2015; 64: 1-64.
(5) Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2018 Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2019; ISBN 978-975-491-493-1
(6) Lyell DJ. Adhesions and perioperative complications of repeat cesarean delivery. Am J Obstet Gynecol. 2011; 205: 11-18.
(7) Phipps MG, Watabe B, Clemons JL, Weitzen S, Myers DL. Risk factors for bladder injury during cesarean delivery. Obstet Gynecol. 2005; 105: 156-160.
(8) Morales KJ, Gordon MC, Bates GW Jr. Postcesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol. 2007; 196: 461.e 1-6
(9) Nisenblat V, Barak S, Griness OB, Degani S, Ohel G, Gonen R. Maternal complications associated with multiple Cesarean deliveries. Obstet Gynecol. 2006; 108: 21-26
(10) Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA et al. Maternal morbidity associated with multiple repeat Cesarean deliveries. Obstet Gynecol. 2006; 107: 1226-1232
(11) Tulandi T, Agdi M, Zarei A, Miner L, Sikirica V. Adhesion formation and morbidity after repeat Cesarean delivery. Am J Obstet Gynecol. 2009; 201: 56. e1-6
(12) Linsky CB, Diamond MP, Cunningham T, Constantine B, DeCherney AH, diZerega GS. Adhesion reduction in the rabbit uterine horn model using an absorbable barrier, TC-7. J Reprod Med. 1987; 32:17-20
(13) Gosain A, DiPietro LA. Aging and wound healing. World J Surg. 2004; 28: 321-326
(14) Dogan NU, Haktankacmaz SA, Dogan S, Ozkan O, Celik H, Eryilmaz OG, et al. A reliable way to predict intraabdominal adhesions at repeat cesarean delivery: Scar characteristics. Acta Obstet Gynecol Scand. 2011; 90: 531-534
(15) Salim R, Kadan Y, Nachum Z, Edelstein S, Shalev E. Abdominal scar characteristics as a predictor of intraabdominal adhesions at repeat cesarean delivery. Fertil Steril. 2008; 90: 2324-2327
(16) Kahyaoglu I, Kayikcioglu F, Kinay T, Mollamahmutoglu L. Abdominal scar characteristics: do they predict intra-abdominal adhesions with repeat cesarean deliveries? J Obstet Gynaecol Res. 2014; 40: 1643-1648.
(17) Taylan E, Akdemir A, Ergenoglu AM, Yeniel AO, Tekindal MA. Can we predict the presence and severity of intra-abdominal adhesions before cesarean delivery. Gynecol Obstet Invest. 2017; 82:521-526.
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