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J Gynecol Obstet Biol Reprod (Paris). 2015 Sep;44(7):621-31. doi: 10.1016/j.jgyn.2014.08.007. Epub 2014 Oct 7.

[Post-cesarean parietal scar characteristics are predictive of pelvic adhesions. A prospective cohort study].

[Article in French]

Author information

1
Service de gynécologie obstétrique, CHU Farhat Hached de Sousse, rue Mohamed-Karoui, CP 4000 Sousse, Tunisie. Electronic address: khlifiabj@yahoo.fr.
2
Service de gynécologie obstétrique, CHU Farhat Hached de Sousse, rue Mohamed-Karoui, CP 4000 Sousse, Tunisie.

Abstract

OBJECTIVE:

To investigate whether abdominal scar characteristics could predict the incidence and severity of intra-abdominal adhesions found at repeat cesarean delivery.

PATIENTS AND METHODS:

Prospective cohort study including 151pregnant women with at least one previous cesarean delivery and who delivered abdominally in the department of obstetrics and gynaecology of Farhat Hached teaching hospital-Sousse-Tunisia, during 6 months. Abdominal scar characteristics were studied. The main outcome measure(s) were the incidence and severity of intra-abdominal adhesions. Statistical analysis was performed using SPSS 18.0.

RESULTS:

Of 151 women enrolled into this trial, 111 (73.5%) had adhesions, 57 (37.8%) had dense adhesions. Of all the abdominal scar characteristics studied, a depressed scar was associated with an increased incidence of both dense and filmy intra-abdominal adhesions and frozen pelvis if compared of women who did not have a depressed scar (P<10(-4) ; RR=7.6; IC=2.98-19.45). A number of previous cesarean section equal or more than 2 was also correlated with an increased incidence of severe intra-abdominal adhesions and frozen pelvis if compared with women who had only one previous cesarean section (P=0.002; RR=2.53; IC=1.16-5.56).

DISCUSSION AND CONCLUSION:

A depressed abdominal scar of a previous cesarean delivery and a number of previous cesarean sections are significantly correlated with the incidence and severity of intra-abdominal adhesions.

KEYWORDS:

Abdominal scar characteristics; Abdominal surgery; Accouchement par césarienne; Adhesions; Adhérence; Caractéristiques de la cicatrice abdominale; Cesarean delivery; Chirurgie abdominale; Prevention; Prévention

PMID:
25304098
DOI:
10.1016/j.jgyn.2014.08.007
[Indexed for MEDLINE]
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