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Rectus muscle and visceral peritoneum closure at cesarean delivery and intraabdominal adhesions 78th Annual Meeting of the Pacific-Coast-Obstetrical-and-Gynecological-Society Lyell, D. J., Caughey, A. B., Hu, E., Blumenfeld, Y., El-Sayed, Y. Y., Daniels, K. MOSBY-ELSEVIER. 2012

Abstract

The purpose of this study was to evaluate the effect of the rectus muscle and visceral peritoneum closure at cesarean delivery on adhesions.We performed a secondary analysis of a prospective cohort study of women who underwent first repeat cesarean delivery. Surgeons scored the severity and location of adhesions. Records were abstracted to assess previous surgical techniques.The original cohort included 173 patients. Rectus muscle closure was associated with fewer combined filmy and dense adhesions overall (27.5% vs 46%; P = .04) and fewer dense adhesions overall (17.5% vs 46%; P = .001; adjusted odds ratio, [aOR], 0.24; 95% confidence interval [CI], 0.09-0.65), particularly from fascia to omentum (aOR, 0.08; 95% CI, 0.007-0.82). Visceral peritoneum closure was associated with increased dense fascia-to-omentum adhesions (aOR, 15.78; 95% CI, 1.81-137.24).Closure of the rectus muscles at cesarean delivery may reduce adhesions, and visceral peritoneum closure may increase them. Surgical techniques at cesarean delivery should be assessed independently, because they may have opposite effects on adhesion formation.

View details for DOI 10.1016/j.ajog.2012.02.033

View details for Web of Science ID 000304442900029

View details for PubMedID 22463952