Effect of closure versus nonclosure of peritoneum at cesarean section on adhesions: a prospective randomized study

Abstract

Objective: We sought to determine the effect of nonclosure of the visceral and parietal peritoneum during cesarean section on the formation of adhesions.

Study design: This was a prospective randomized trial of 533 women undergoing primary cesarean section; in 256 the peritoneum was left open and in 277 it was closed. Fifty women in the nonclosure group and 47 women in the closure group were subsequently evaluated intraoperatively at a repeat cesarean. The presence of adhesions and their severity were evaluated at several sites.

Results: The nonclosure and closure groups were comparable with regard to the proportion of patients with adhesions at any site (60% vs 51%, respectively; P = .31). Time from incision to delivery was comparable in the nonclosure and closure groups (8.98 ± 4.7 vs 9.32 ± 5.2 minutes, respectively; P = .84).

Conclusion: Closure or nonclosure of the peritoneum at cesarean section did not lead to large differences in the adhesion rate.