A retrospective study on adhesions in cesarean section patients

Objective: The purpose of this study was to estimate the incidence, site and density of adhesions after cesarean deliveries.
Material & Methods: This was a retrospective study carried out in the Department of Obs. and Gynae in NDMC Medical College & Hindu Rao Hospital, Delhi from November 2018 till January 2019. The medical records of 198 patients who underwent cesarean during this time were reviewed. The incidence, severity, and locations of adhesions and post-operative color of urine were noted.
Results: Out of 198 patients,114 were primary cesareans, 69 were one previous cesarean 14patients had 2 previous cesareans and only 1 patient had 3 previous cesareans. Only one patient in the primary cesarean had flimsy adhesions. After the first cesarean delivery, of 56.5% women had pelvic adhesive disease but 73.3% of women with previous 2 cesareans. Density of adhesions increased with increasing number of cesareans. Adhesions were mainly present between the uterus and anterior abdominal wall, Uterus and urinary bladder and sometimes both the tubes and ovaries could not be even seen due to dense adhesions.
Conclusion: Adhesions are common after CD and their incidence increases with each subsequent procedure.60% of cesarean deliveries results in adhesive disease. The density of adhesions also increases with increasing number of previous cesareans. Sometimes we may land up doing classic cesarean due to dense adhesions. The potential for adhesive disease should be included in counselling regarding primary elective cesarean births.