Should Parietal Peritoneum be closed at Primary Cesarean Section?

Bhat, Parvati V and Kumar, Pratap and Mayya, Shreemathi S (2009) Should Parietal Peritoneum be closed at Primary Cesarean Section? J Obstet Gynecol India, 59 (3). pp. 220-223.

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Objectives: The main aim for undertaking this study was to determine the relationship between the closure of parietal peritoneum and subsequent adhesion formation. Our aim was also to find out the type of adhesions between parietal peritoneal closure and non closure. Methods: A retrospective study from the records of women who came for their repeat cesarean section was done for a period of five years from 1999 to 2003. Results: There were 402 women who met the inclusion criteria in the study. All the cases included in our study had Pfannenstiel incision during their primary cesarean section (CS). No muscle cutting incision was used in any case. Of the 402 cases 223 (55.47%) had peritoneal closure and 179 (44.52%) cases did not have peritoneal closure. Looking through the data we found that in peritoneal closure of 223 cases, 40 (17.9%) had adhesions, while 183 cases (82.06%) had no adhesions. In the non peritoneal closure group, out of 179 cases, 121 (67.59%) had adhesions, while 58 (32.40%) did not have adhesions. In the peritoneal closure group, out of 40 cases 13 (32.50%) had dense adhesions, while 27 (67.50%) had flimsy adhesions. In the peritoneal non closure of 121 cases, 82 (67.76%) had dense adhesions, while 39 (32.23%) had flimsy adhesions. Using statistical significance, Pearson chi square value =101.992, P<0.001 and odds ratio, we found a 9.5 fold increase in adhesions in the peritoneal non closure group and even dense adhesions were found to be increased by 3.6 fold (X2=10.69, P=0.001 OR = (1:6;7.7) in the peritoneal closure group. Conclusion: As the adhesion formation is less in the peritoneal closure group, it is advisable to close the parietal peritoneum during primary cesarean section. The uterus was sutured in two layers with No.1 NW 2347 vicryl and peritoneum with No. 0 chromic NW 4242 with atraumatic needle.

Item Type: Article
Uncontrolled Keywords: Cesarean section, Parietal peritoneum closure, Adhesion formation
Subjects: Departments at MU > Statistics
Medicine > KMC Manipal > Obstetrics & Gynaecology
Depositing User: KMC Manipal
Date Deposited: 19 Apr 2012 09:33
Last Modified: 05 Nov 2016 09:31

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