The correlation between Intra-abdominal Adhesions and body mass index in Women Undergoing elective repeated Cesarean Section

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Background: Intra-abdominal adhesion formation is serious post-surgery problem that occurs frequently after caesarean section. Obesity is associated with many hemostasis disturbances, particularly impaired fibrinolysis, which may increase the incidence of intra-abdominal adhesions. Aim of Work: Goal of the work was to correlate between intra-abdominal adhesions and body mass index in women scheduled for a repeated cesarean section. Patients & Methods: This was observational cross-sectional research that was carried out at Obstetrics & Gynecology department, faculty of medicine, Al-Azhar university hospitals during the period between October 2021 and April 2022, and total of 232 pregnant women undergoing repeated cesarean section, were enrolled in our study. They were separated into 2 categories according to the BMI: Category I: BMI < thirty kg/m2 (N = 30) and Category II: BMI ≥ thirty kg/m2 (N = 202); Group IIa (N = 96): BMI thirty – 34.9 kg/m2; Group IIb (N = 81): BMI thirty five – 39.9 kg/m2, and Group IIc (N = 25): BMI ≥ 40 kg/m2. Results: no statistically significant variation was discovered among categories regarding preoperative Hgb. However, group II was associated with more significant blood loss compared to group I. Furthermore, the incidence of intraoperative visceral injuries was greater in category II compared to category I. Conclusion: in women undergoing cesarean section, there was a significant association between body mass index and formation of intra-abdominal adhesion with no effect on scar thickness, more frequent depressed scar and dense adhesions, larger adhesion size, longer operation duration and no effect on intraoperative bleeding.

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