Effect of Multiple Repeat Cesarean Sections on Intra-Abdominal Adhesions

Background: Cesarean section (CS) births have substantially grown during the past several decades all across the world.Multiple caesarean sections are linked to a higher risk of placenta previa, abdominal adhesions, ureteric, bladder, and bowel injuries, as well as uterine rupture and dehiscence.When previous procedures cause inflammation and damage normal tissue, fibrous, band-like formations called abdominal and pelvic adhesions develop between the abdominal organs.The current study aims to compare the rate of adhesions based on number of CSs.Patients and methods: A total of 160 patients were recruited and divided into two groups: women with ≤3CS (100 patients) and women with ≥4 CS (60 patients).In the first group, 15 women had dense adhesions, 43 had filmy adhesions and 42 had no adhesions, and in the second group 42 women had dense adhesions, 15 women had filmy adhesions and only 3 had no adhesions.Results: Operative data of both groups had important differences where women with ≥4 CS had significantly higher Nair's score and modified Nair's score compared with women with ≤3CS.Frequency of bladder injury was significantly lower among women with ≤3CS.Women with ≥4 CS had significantly higher amount of suction and longer duration of operation.Conclusion: Multiple cesarean sections are associated with increased risk of intra-abdominal adhesions, bladder injury and longer operation time.Post-operative complications included wound infections and need for blood transfusions.