International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022
Prevalence and risk factor of postoperative adhesions following repeated cesarean section: A prospective cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Aboshama Rehab Abdelhamid, Taha Omima T, Abdel Halim Hala Waheed, Elrehim Eman Ibrahim Abd, Kamal Shaimaa Hanafy Moustafa, ElSherbiny Ahmed Mohamed, Magdy Hagar Abdelgawad, Albayadi Eslam, Elsaid Rasha Ezzat, Abdelghany Amany Mohamed, Anan Mohamed A, Abdelfattah Laila Ezzat
Аннотация
OBJECTIVE: To evaluate the prevalence of intraperitoneal adhesions after repeated cesarean delivery and its associated personal and surgical risk factors.
METHODS: This prospective cohort study was conducted at the delivery ward at Fayoum University Hospital from October 2020 to December 2021. Women were recruited according to predetermined inclusion and exclusion criteria. Eligible women were interviewed, and data were obtained for personal history, past surgical and obstetrical history, and data about the current delivery. Nair's scoring system was used to evaluate intraperitoneal adhesions. Postoperative data and complications were reported.
RESULTS: Three hundred women were recruited. Moderate to severe adhesions occurred in 186 patients (62%). These patients had a significantly prolonged hospital stay and were delivered by expert surgeons (P < 0.001 and P = 0.008, respectively). The adhesion score correlated positively with patients' age (P < 0.001), parity (P < 0.001), interpregnancy interval (P = 0.033), duration of hospital admission either previously or in the current delivery (P = 0.001 and P < 0.001), time to ambulation (P < 0.001), time to intestinal movement (P < 0.001), operative time (P < 0.001), and surgeons' age and experience (both P = 0.015).
CONCLUSION: Adhesions led to increased maternal morbidity. Multiple contributing factors were significantly related to adhesions with multiple cesarean deliveries.
METHODS: This prospective cohort study was conducted at the delivery ward at Fayoum University Hospital from October 2020 to December 2021. Women were recruited according to predetermined inclusion and exclusion criteria. Eligible women were interviewed, and data were obtained for personal history, past surgical and obstetrical history, and data about the current delivery. Nair's scoring system was used to evaluate intraperitoneal adhesions. Postoperative data and complications were reported.
RESULTS: Three hundred women were recruited. Moderate to severe adhesions occurred in 186 patients (62%). These patients had a significantly prolonged hospital stay and were delivered by expert surgeons (P < 0.001 and P = 0.008, respectively). The adhesion score correlated positively with patients' age (P < 0.001), parity (P < 0.001), interpregnancy interval (P = 0.033), duration of hospital admission either previously or in the current delivery (P = 0.001 and P < 0.001), time to ambulation (P < 0.001), time to intestinal movement (P < 0.001), operative time (P < 0.001), and surgeons' age and experience (both P = 0.015).
CONCLUSION: Adhesions led to increased maternal morbidity. Multiple contributing factors were significantly related to adhesions with multiple cesarean deliveries.