Association between peritoneal closure at primary cesarean section and significant adhesions at second cesarean section

ABSTRACT

To evaluate impact of peritonization at primary cesarean section in terms of abdominopelvic adhesions at second cesarean section. A randomized trial. Women undergoing first cesarean delivery were randomized to either closure of both the visceral and parietal peritoneum [Group A, n =150] or non closure [Group B, n=150]. At second cesarean, the variety and frequency of adhesions were examined. The incidence of adhesions in the closure group was significantly higher than in the non closure group [p<0.05]. The mean total operating time and the mean interval from skin incision to delivery in the closure group was significantly longer than in the non closure group [P <0.05, P<0.05 respectively] at second cesarean section. Peritoneal closure in cesarean delivery is associated with significant adhesion formation. The practice of non-closure of peritoneum is therefore recommended