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NEW ORLEANS -- Peritoneal closure at the time of primary cesarean section decreases adhesion formation, Dr. Deirdre Lyell reported at the annual meeting of the Society for Maternal-Fetal Medicine.
In a prospective study of 175 women undergoing a first repeat cesarean section, prior peritoneal closure was associated with a fivefold overall reduction in adhesion formation (odds ratio 0.19), and a threefold reduction in dense adhesions, compared with nonclosure, said Dr. Lyell of Stanford (Calif.) University.
Surgeons performing the repeat cesarean section in study participants scored the location and severity of adhesions immediately following the surgery. Prior peritoneal closure was associated with significantly decreased adhesions of the omentum to the fascia (odds ratio 0.16) and of the uterus to the fascia (odds ratio 0.18); there was a trend toward decreased omentum to uterus adhesions (odd ratio 0.39).
Closure of the rectus muscle was also protective against adhesion ...