Abstract
The increasing rate of cesarean sections (CS) raises concerns over severe intra-abdominal adhesions, which are associated with numerous complications. We aimed to identify risk factors and predictive tools for severe adhesions. In a prospective study at a tertiary medical center from January-July 2021, women with at least one prior CS were evaluated. Surgeons assessed adhesions at four anatomical sites, scoring them from 0 (none) to 2 (dense), with a total possible score of 0-8. Severe adhesions were defined as a score of ≥5. Risk factors were analyzed using logistic regression to create a prediction model. Overall, 341 women were included in the study. Significant predictors included the number of previous CS, maternal BMI, maternal morbidity at the time of the previous CS, and operation time. The model predicted severe adhesions with 79.1% accuracy, a positive predictive value of 68.4%, and a negative predictive value of 79.5%. The severity of most cases of post-CS adhesions can be predicted by a model which considers common risk factors.
Published Version
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