Comparison of Closure and Nonclosure of the Peritoneum at Previous ?Cesarean Delivery and Incidence of Significant Adhesions at Repeat Cesarean ?Section
Trauma Monthly: 12 (2); 175-179 Article Type: Research Article
January 1, 2007
January 1, 2007
M. Comparison of Closure and Nonclosure of the Peritoneum at Previous ?Cesarean Delivery and Incidence of Significant Adhesions at Repeat Cesarean ?Section,
Online ahead of Print
Objective. Abdominal operations is associated with celiac adhesions this study compares the frequency and severity of adhesions following cesarean sections performed with and without closure of the parietal and visceral peritoneum Material and Methods. A prospective cohort study of women undergoing first repeat cesarean delivery was designed. All surgeons were asked immediately after surgery to score the severity and location of adhesions. Patient records were then abstracted to assess prior surgical technique, including parietal peritoneal closure, other attributes of first surgery, and patient characteristics. The chi square test and multivariable logistic regression were used for statistical comparison and analysis. Results. One hundred fifty patients were enrolled. (70 patients with Prior parietal peritoneal nonclosure and 80 patients with Prior parietal peritoneal closure): closure of the parietal peritoneum at the time of the first cesarean section was associated with significantly less visceral adhesions than closure (45% versus 77%, P = .006) and significantly fewer dense adhesions (33% versus 48%, P = .03). Conclusion. Parietal peritoneal closure at primary cesarean delivery was associated with significantly fewer and filmy adhesions. The practice of nonclosure of the parietal peritoneum at cesarean delivery should be questioned.
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