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Adhesion Rate for Repeat Cesareans Analyzed

A quarter of second-time cesareans affected, slowing down delivery

TUESDAY, July 14 (HealthDay News) -- Adhesions affect almost a quarter of all second-time cesarean sections, and the rate of adhesions increases with subsequent cesareans, slowing down time to each successive delivery, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.

Togas Tulandi, M.D., of McGill University in Montreal, and colleagues reviewed the charts of 1,283 women who had undergone repeat cesarean section delivery and 203 who underwent a primary cesarean section.

The researchers found that, among the women who had undergone just one cesarean section, there was no evidence of adhesions, but adhesions were found in women who had undergone two, three, and four or more cesareans in 24.4, 42.8, and 47.9 percent of cases, respectively. Complication rates were similar for women after one cesarean and multiple cesareans, but the delivery time was longer when there had been multiple cesareans -- 7.7 minutes for the first, 9.4 minutes for the second, 10.6 minutes for the third, and 10.4 minutes for the fourth or subsequent cesarean, the investigators discovered.

"Total adhesions scores among all groups were similar, which suggests similar adhesion density in patients across repeat cesarean deliveries," the authors write. "However, the proportion of adhesion sites to number of patients and the proportion of dense adhesion sites increased steadily across second, third, and greater than of equal to four cesarean deliveries, which implies that more adhesion sites and more dense adhesion sites are involved with each subsequent cesarean delivery."

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