Background: Intra-abdominal adhesion formation is an important post-surgery complication and develops at an incidence of 24–83% following cesarean section. Obesity is associated with several disturbances in hemostasis, especially impaired fibrinolysis that may increase incidence of intra-abdominal adhesions.
Aim of the Work: Evaluation of the association between body mass index and formation of intra-abdominal adhesion in women undergoing cesarean section.
Patients and Methods: Two hundred and ten pregnant women of at least 37 weeks' gestation with history of prior cesarean section were included and divided into two groups according to body mass index (BMI) upon cesarean section (<30 kg/m2 and ≥30 kg/m2). The intra-abdominal adhesion incidence and the scar characteristics of the groups were compared.
Results: In obese cases, scar thickness was significantly higher 8.7 ± 1.2 vs. 7.3±1.1 mm, different adhesion sites (uterus-bladder, omentum-fascia, uterus-omentum and uterus-fascia) were significantly more frequent, dense adhesion consistencies were more frequent and adhesion size was higher in obese cases. Operative duration was significantly longer in obese cases 40.0 ± 3.0 vs. 36.9 ± 4.0 minutes. Operative complications were non-significantly more frequent in obese cases.
Conclusion: In women undergoing cesarean section, there was a significant association between body mass index and formation of intra-abdominal adhesion.