Cesarean deliveries are now the most commonly performed abdominal surgery in the United States. In 2005, an estimated 30.3 % of all births involved C-section procedures, and preliminary estimates from the Centers for Disease Control and Prevention indicate that the incidence of C-sections will continue to rise in the coming decade.
Cesarean deliveries are now the most commonly performed abdominal surgery in the United States.1 In 2005, an estimated 30.3 % of all births involved C-section procedures2, and preliminary estimates from the Centers for Disease Control and Prevention indicate that the incidence of C-sections will continue to rise in the coming decade.3
The increased use of C-section procedures presents some important health considerations for specialists in maternal fetal medicine. According to the results of a study published in the American Journal of Obstetrics & Gynecology in May 20071:
The Rationale for Proactive Strategies to Prevent Adhesions in C-Sections
Time to infant delivery once anesthesia has been administered and risk of surgical complexity at repeat C-section are of critical concern, particularly in cases of emergent C-section. Based on these findings and continuing trends in the incidence and impact of C-sections, obstetrical practices are increasingly considering strategies to help reduce the risk of adhesions. In some practices, strategies focus on restrictions in the use of C-section procedures among patients. The availability of proven adhesion prevention strategies has also built support for a more proactive strategy to reduce risk, especially among patients treated with multiple C-section procedures. Following a comprehensive review of options, our division led a practice-wide initiative to incorporate adhesion prevention strategies to reduce the risk of adhesions in most C-section procedures.
In considering this plan, which was introduced in 2005, we identified several factors in support of a more proactive adhesion prevention strategy:
The availability of more conclusive data related to the risk of adhesions among C-section patients will help to shape even more effective prevention strategies in the years ahead. In this area, however, the rapid increase in C-section procedures challenges us to identify the optimal strategies to reduce patient risk as quickly as possible. While available data related to the morbidity associated with C-section adhesions are limited, we concluded that available data are sufficient at this stage to support a broad preventative intervention strategy as outlined. We are continuing to monitor results based on this strategy to draw more precise conclusions related to treatment experience.
1. Morales KJ, Gordon MC, Bates GW Jr. Post cesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol 2007;196:461.e1-461.e6.
2. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, Munson ML. Births: Final data for 2005. National vital statistics reports; vol 56 no 6. Hyattsville, MD: National Center for Health Statistics 2007.
3. Hamilton BE, Martin JA, Ventura SJ. Births Preliminary data for 2006. National vital statistics reports; vol 56 no 7. Hyattsville, MD: National Center for Health Statistics. 2007.