The Association between Body Mass Index and Intra-abdominal Adhesions in Women Undergoing Repeat Caesarean Sections

Background: Worldwide, the number of women who undergo repeat cesarean sections (CDs) is on the rise. Planned repeat cesarean deliveries are performed by almost 90% of pregnant women who have had one before. Repeated cesarean sections increase the incidence and severity of intra-abdominal adhesions, which are common after these procedures. Possible complications of adhesiolysis include prolonged fetal extraction, damage to surrounding viscera, and hemorrhage. Aim and objectives: To assess whether or not obese individuals who are planning a repeat cesarean section are at a greater risk of developing intra-abdominal adhesions. Patients and methods: Six hundred pregnant women were the subjects of an observational cross-sectional study that ran Between January and December of 2023 at the Al-Hussein University hospital's Obstetrics and Gynecology department. Results: Regarding the degree of adhesions between the uterus and other organs, we observed a statistically significant difference among the studied group. Women with a body mass index(BMI)≥35 kg/m2 (Group 2c) had the highest median adhesion scores for uterus-bladder(7), uterus-abdominal fascia(15), and uterus-other pelvic organs(8) adhesions compared to the other BMI groups. These findings suggest that obesity is a significant risk factor for the development of intra-abdominal adhesions, particularly in the pelvic region. Conclusion: Patients experiencing repeat cesarean deliveries are more likely to develop intra-abdominal adhesions and sustain visceral injuries if they are obese. These findings highlight the importance of considering obesity as a risk factor and implementing appropriate preventive measures to minimize adhesion formation and associated complications in obese patients undergoing abdominal surgeries.