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| Analysis of pelvic and peritoneal adhesion during the second cesarean section |
| Jiaozhou Central Hospital, Qingdao, Shandong Province, 266300 |
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Abstract To analyze the risk factors pelvic and peritoneal adhesion and preventive measures of women with scar uterus during the second cesarean section. Methods: The clinical data of the women with scar uterus who underwent the second cesarean section from May 2018 to September 2020 were collected retrospectively. 75 women with pelvic and peritoneal adhesion found during the second cesarean section were in study group, and 75 women without pelvic and peritoneal adhesion found during the second cesarean section were in control group. Multivariate Logistic regression analysis was used to analyze the related factors affecting pelvic and peritoneal adhesion after the first cesarean section. Results: the pelvic and peritoneal adhesions of the women found during the second cesarean section were not related to the timing of the first cesarean section or the degree of cervical opening before the first cesarean section (P>0.05), but were correlated with the interval between the two cesarean sections, age, incision type, amniotic fluid pollution and its pollution degree (P>0.05). The severity of pelvic and peritoneal adhesions was related to the amount of blood loss during cesarean section, postoperative infection, operation time, hospital stay, neonatal asphyxia, and the time from began operation to delivery (P<0.05). Multivariate logistic regression analysis showed that amniotic fluid contamination and high degree of contamination, transverse incision of the first cesarean section, interval of the two cesarean sections <2 years, and≥35 years old were the independent risk factors of pelvic and peritoneal adhesions (P<0.05). Conclusion: The possible factors that lead to pelvic and peritoneal adhesion of the women with scar uterus after cesarean section should be paid attention to in clinic. And proactive measures should be taken to protect the health of pregnant women and fetus by reducing the number of cesarean section, prevent amniotic fluid pollution, choose longitudinal incision during cesarean section, and so on.
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