Cesarean Section Scar Characteristics in Subjects with and without Intra-abdominal Adhesions at Taleghani Hospital in Tehran, Iran in 2016

  Candidates of cesarean section with a previous history of such surgery are at a higher risk of intra-abdominal adhesions in comparison to those having undergone vaginal delivery. Intra-abdominal adhesions lead to prolonged operative time, intraoperative hemorrhage, fetomaternal morbidity, and requirement of the help of other surgeons. Therefore, this study was conducted to study the characteristics of abdominal scars in order to predict and manage intra-abdominal adhesions before operation. This descriptive prospective study was conducted on 109 candidates of cesarean section with a previous history of such surgery in Taleghani Hospital, Tehran, Iran, in 2017. The data recorded for each patient included demographic characteristics, body mass index, abdominal scar characteristics, and severity of abdominal adhesion. The collected data were analyzed in SPSS software (version 22) using the Chi-square test and Mann-Whitney U test. P-value less than 0.05 was considered statistically significant. Out of 109 participants, 36 (32.02%) women had adhesion, 17 (15.6 %) cases of whom had dense vascular adhesions or frozen pelvis. The analysis showed a significant difference between the filmy adhesion or non-adhesion group and adhesive adhesion or frozen pelvis group in terms of flat and non-flat scars (P=0.042), scar height
(P=0.005), and depressed and non-depressed scars (P=0.004). As the findings indicated, a depressed abdominal scar resulting from a previous cesarean delivery was correlated with the incidence and severity of intra-abdominal adhesions (P<0.05).