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Closure vs. nonclosure of the peritoneum at cesarean delivery
Author(s) -
Yiyang Zhu,
Qunxi Cai,
Weiling Wu
Publication year - 2006
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2006.05.003
Subject(s) - medicine , peritoneum , surgery , retrospective cohort study , confounding
Objective To compare the frequency and severity of celiac adhesions following cesarean sections performed with and without closure of the parietal and visceral peritoneum. Methods A retrospective cohort study involved 612 women who underwent their second lower‐segment transverse cesarean section. Results Nonclosure of the parietal peritoneum at the time of the first cesarean section was associated with significantly more visceral adhesions than closure (16.2% vs. 8.1%; P = 0.003), and closure of the visceral peritoneum had a similar effect (16.1% vs. 6.7%; P = 0.02). However, the difference in rates of severe adhesions was not statistically significant (12.9% vs. 17.6%; P = 0.12). After controlling for confounding variables, it was found that closure of the parietal peritoneum reduced the rate of visceral adhesions 2.7‐fold. Trial of labor before and fever after surgery increased the risk of severe adhesions 6.1‐fold and 5.6‐fold, respectively. Conclusion Nonclosure of the peritoneum at primary cesarean section is associated with a significantly increased risk of visceral adhesions.