Surgeons Re-Assess C-Section Procedure

A much-debated practice may reduce scarring, study finds

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MONDAY, Aug. 1, 2005 (HealthDay News) -- Surgeons may have found a method of reducing C-section-linked scarring and increasing the safety of subsequent Caesareans.

Closing the parietal peritoneum -- a multi-layered membrane that lines the abdominal-pelvic walls -- after a woman has had a C-section greatly lowers the likelihood of scarring, say researchers at the Stanford University School of Medicine.

When surgeons perform a C-section, they must cut through the parietal peritoneum. There's ongoing debate about whether it's best to surgical repair this membrane after a C-section or allow it to heal on its own.

Writing in the August issue of Obstetrics and Gynecology, the California researchers pointed out that their finding contradicts current thinking among many surgeons.

"This was a surprise finding," study lead author Dr. Deirdre Lyell, assistant professor of obstetrics and gynecology, said in a prepared statement. "We were fully expecting to find that closing the peritoneum at Caesarean delivery would increase adhesions."

Adhesions are scars that form abnormal connections between two parts of the body.

The study of 173 with repeat C-sections found that 53 percent of women whose peritoneum was surgically closed following their first C-section delivery developed abdominal adhesions, compared with 73 percent of women who didn't have the surgery.

The researchers concluded that surgical closure of the peritoneum provided five times as much protection against the formation of abdominal adhesions, compared with leaving the membrane to heal on its own.

Based on their findings, the study authors wrote that, "the practice of non-closure of the parietal peritoneum at Caesarean delivery should be questioned."

However, they said more research is required to provide a definitive answer.

More information

The March of Dimes has more about Caesarean section.

SOURCE: Stanford University, news release, July 28, 2005

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