EFFECT OF CLOSURE VERSUS NON-CLOSURE OF PARIETAL PERITONEUM AT CAESAREAN SECTION ON ADHESION FORMATION.

Volume 11 , Issue 4 , December 2021 , Pages 437-442

Authors

Gona Aziz Rahem 1

1 Maternity Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10329

Keywords

Abstract

Background
Caesarean section (CS) is a standard obstetric procedure, and it is rate increasing worldwide. However, intraabdominal adhesion is one complication of caesarean section and other obstetric and gynaecological surgeries.
Objectives
This study aims to compare the frequency and severity of post-surgical adhesions among patients with closed
and non-closed parietal peritoneum at their first caesarean section.
Patients and Methods
A cross-sectional study was conducted in maternity and private hospitals in Sulaymaniyah/Kurdistan/Iraq,
from July 2015 to December 2020. Involved 190 pregnant ladies entered second CS at term. Patient records
were then abstracted to assess prior CS techniques, including parietal peritoneal closure, which the same
obstetrician did. A total of 190 patients were checked for that purpose; each was checked to know whether she
has intra-abdominal adhesion or not and at the same time to know whether her previous CS was performed
by peritoneal closure or not. The main parameters were adhesion formation in the second CS and the type of
adhesion. The maternal age, occupation, parity, and gestational age were also recorded—Chi-square test used
for statistical analysis of variables.
Results
Based on the outcome, two groups (one with peritoneal closure and the other without it) were identified, they
were compared regarding their maternal age, parity, gestational age and occupation. There was significantly
more adhesion between the omentum and Scarpa fascia in the non-closure group (28.3%) compared to (13.1%)
in the closure group with (p-value 0.01), which is significant. On the other hand, filmy adhesion was more
in the closure group (63.6%), while thick adhesion was more in the non-closure group (53.3%) with (p-value
0.34), which is not significant.
Conclusion
Parietal peritoneum closure at first caesarean section was associated with less adhesion formation. Therefore,
the practice of non-closure of parietal peritoneum at caesarean delivery is not recommended.

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  • Published at21 December 2021

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