Table 2 Randomized and prospective studies with unclear evaluation of adhesions
From: Classification of intra-abdominal adhesions after cesarean delivery
Authors | Type of study | Main outcome measures | Number of patients analyzed | Results | Comments |
|---|---|---|---|---|---|
Roset et al. [13] | Randomized clinical trial | Effect of combined parietal and visceral peritoneum closure | 29 | No difference in long-term morbidity between closure and non-closure of peritoneum | Outcomes were evaluated by patient report |
Weerawetwat et al. [14] | Randomized clinical trial | Effect of parietal and visceral peritoneum closure | 65 | No difference in adhesion formation between closure and non-closure of peritoneum | Adhesion score (no, mild, moderate and severe) based on the width of the adhesion bands; lack of detailed description of site-specific adhesions |
Komoto et al. [15] | Prospective cohort | Effect of combined parietal and visceral peritoneum closure | 50 | Increased adhesion formation with parietal and visceral peritoneum closure | Frequency of adhesions was evaluated, and severity was based on whether adhesiolysis was performed |
Salim et al. [16] | Prospective cohort | Relationship between abdominal scar characteristics and adhesions | 107 | Depressed previous scar is associated with increased adhesions. | Adhesion severity: light filmy or dense vascular |
Malvasi et al. [17] | Prospective cohort | Effect of visceral peritoneum closure | 112 | Increased adhesions with visceral peritoneum closure | Evaluation of mainly adhesions between the bladder and the uterus. Severity of adhesions was graded using the American Fertility Society classification for adnexal adhesions |
Zareian et al. [18] | Randomized clinical trial | Effect of combined parietal and visceral peritoneum closure | 31 | Parietal and visceral peritoneum closure may decrease adhesion formation | Adhesion score based on the ease of removal of adhesion bands between the uterus and omentum or rectus muscle. Small number of cases |