Necessity of Parietal Peritoneum Layer Closure to Prevent Severe Adhesion in Repeat Caesarean Section

Background: Repeated cesarean section involves various complication and one of the most common is adhesion. Some studies suggest that by closing the parietal peritoneum layer, the adhesion rate after surgery can might be decreased. The aim of this study was to assess the necessity of parietal peritoneum layer closure to prevent severe adhesion in repeat caesarean section.Material & Methods:This cross-sectional study was conducted in department of obstetrics and gynaecology, Care Medical College Hospital, Dhaka, Bangladesh from 2020 to 2022. Total 100 pregnant women were included in this study. These patients were divided into two groups where each groups contained 50 pregnant women. Here the two groups are parietal peritoneum layer closure and of parietal peritoneum layer non-closure.Results:Mean age of the pregnant women was 28.6 years (SD±4.50 years) in parietal peritoneum layer closure group and 30.4 years (SD±4.91 years) in parietal peritoneum layer non-closure group. 58% pregnant women in parietal peritoneum layer closure group and 60% in parietal peritoneum layer non-closure group had short inter delivery interval. The commonest comorbidity was hypertension in both groups (22% and 20%). Mean operating time was 35.6 minutes (SD±8.93 minutes) in parietal peritoneum layer closure group and 32.4 minutes (SD±9.50 minutes) in parietal peritoneum layer non-closure group. Mean hospital stay was 4.2 days (SD±1.01 days) in parietal peritoneum layer closure group and 4.8 days (SD±1.02 days) in parietal peritoneum layer non-closure group. The adhesion rate was 12% in parietal peritoneum layer closure group and 28% in parietal peritoneum layer non-closure group. The parietal peritoneum layer closure group had adhesion commonly in fascia to uterus (4%) and omentum to uterus (4%). The parietal peritoneum layer non-closure group had adhesion commonly in omentum to fascia (12%).Conclusion:Closure of the parietal peritoneum layer in caesarean section resulted in less adhesion formation. Thus, it is necessity to perform parietal peritoneum layer closure to prevent severe adhesion in repeat caesarean section.