Congratulations on your pregnancy, Mama! While you prepare for the arrival of your precious little one, it’s important that you feel prepared and understand how to care for yourself after giving birth. One of the things you need to be aware of is the recovery process, should you undergo a C-section, as C-section births are becoming increasingly common in Singapore.
The percentage of c-section births in the 1990’s was 10-15%. In 2017, this rose to an estimated 45% of births1. Therefore, it is important to equip yourself with knowledge about a lesser-known C-section complication – that is internal scarring, also known as “adhesions.”
What Are Adhesions?
Adhesions, a potential C-section complication, are fibrous bands of scar tissue that join two or more internal body structures together.2 The adhesion develops when the body’s repair mechanisms respond to tissue disturbance, such as surgery, infection, trauma or radiation, which then results in inflammation.
Adhesions can take on different appearances: sometimes, they can be as thin as tissue similar to plastic wrap but sometimes, they appear as thick fibrous bands. Although these can appear anywhere, the most common locations are within the abdominal cavity, the pelvis and around the heart.
Although these adhesions are little known and seldom talked about, they are sadly very common. In fact, nearly half of women (46%) develop adhesions after their first C-section3 and the risk rises to 75% by their third C-section3.
Therefore, it is key for mums to understand what can be done to prevent, and repair adhesions. Surgical intervention is not the only way to repair these.
Adhesions Complications Following C-section
This potential C-section complication is more concerning than a simple aesthetic issue. Post-surgical adhesions may cause serious complications such as:
- Infertility (20-40% of cases are caused by adhesions) 4
- Small Bowel Obstruction that prevents normal flow of contents through the digestive tract. (74% of cases are adhesion-related)4
- 67% risk of ectopic pregnancy5
- Bladder adhesions5
- Increased infant delivery time for future childbirths, thus requiring longer operating time6
- Chronic pelvic pain5
- Difficulty in future surgeries4
These complications may require further surgical intervention, which, apart from being costly is also not without risk. Adhesion surgery is incredibly complex, and there is a real risk of impacting other organs during surgery (for example, accidental enterotomy which is cutting through the intestinal wall)4.
How To Prevent Adhesions With Various Types of Barriers7
Mums, while the complications of adhesions do pose a significant risk, the good news is, you can try and prevent these. There are a number of solutions to prevent adhesions from forming.
1. Your surgeon can place a site specific adhesion barrier membrane on the uterus or under the incision upon delivering your baby. These are made from compounds found naturally in the body’s connective tissue, fluid in joints as well as the umbilical cord so it is safe for use. These have been used across the globe for over two decades.8
2. Application of Hyaluronic Acid gel over the incision through a syringe. This is also made of components from the human connective tissue and is safe for use.
3. Placing a mesh-like barrier (oxidised regenerated cellulose barrier) over or above the incision.
A C-section is not something you should fear. Knowing what you’re in for, and understanding how to prevent potential complications empowers you to take the best care of yourself and recover well.
Don’t let lesser-known post-surgery risks become a reality for you.
Speak to your doctor about this and take the necessary steps to protect yourself. You can opt for these well established adhesion barriers, that are efficient and safe options.
Remember, your recovery is crucial for you to be a happy and healthy mum to raise a happy and healthy child!
Educational article brought to you by Baxter.
References:
(1) https://www.pacificprime.sg/blog/c-sections-in-singapore/
(2) Sikirica et al. The inpatient burden of abdominal and gynecological adhesiolysis in the US. BMC Surgery 2011, 11:13
(3) Morales KJ, Gordon MC, Bates GW. Postcesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol. 2007; 196 (5): 461-466.
(4) De Wilde R. Trew G. Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Gynecol Surg. 2007;4:161-68.
(5) Awoniyi O. Awonuga, Nicole M. Fletcher, Ghassan M. Saed, et al. Postoperative Adhesion Development Following Cesarean and Open Intra-Abdominal Gynecological Operations. Reprod Sci. 2011 Dec; 18(12): 1166-1185.
(6) TulandiT, Agdi M, Zarei A, et al. Adhesion development and morbidity after repeat cesarean delivery. Am J Obstet Gynecol 2009;201 :56.e1-6.
(7)www.asiaone.com/health/devices-stop-organs-sticking-together#gsc.tab=0
(8) Diamond MP, Burns EL Accomando B. et al. Seprafiim® adhesion barrier: (2) a review of the clinical literature on intraabdominol use. Gynecol Surg. 2012:9(3):247-57.