Complications of c-sections
Bowel obstruction is also a fairly common result of surgical adhesions. Sometimes scar tissue forms over the small intestine, causing a blockage in your bowel.
As a result, your bowel cannot excrete any waste, causing side effects like nausea, vomiting, and pain. Bowel obstruction can occur immediately after surgery or it can develop years later.
Very rarely, surgical adhesions can impair a woman’s fertility. If adhesions form between the ovaries or fallopian tubes, it may be impossible for sperm to enter to fertilize an egg. These adhesions may also make it difficult for an egg to travel through your fallopian tubes.
Birth After Cesarean Section
If you have had a cesarean section and are pregnant or planning to have another child, these adhesions could complicate matters. If you are having another c-section, your health care provider will have to separate and cut through all of your adhesions before she can begin the c-section.
For women who have had more than three cesareans, this could take ten minutes to an hour or more. In an emergency, this could place your baby at risk.
If you elect to have a vaginal birth after a cesarean , or VBAC, adhesions shouldn’t pose much of a problem, unless you have had multiple cesarean sections. Typically, women who have only had one cesarean section can deliver vaginally without any difficulties.
There is a chance that the scar tissue covering the incision in your uterus could rupture. This can be very dangerous, as it can cause massive bleeding or cut off your baby’s oxygen supply.
However, the risk of uterine rupture during a VBAC is very low, typically occurring in less than 1 out of every 1,000 births.
Treating Cesarean Section Adhesions
Cesarean section adhesions can be treated in order to reduce pain or restore fertility. Adhesions are separated and removed through a surgical procedure.
These procedures are highly successful, and generally help 60% of all patients. However, surgical adhesions can form again, and do so in about 70% of cases.
Preventing Cesarean Section Adhesions
Recent studies have shown that the adhesions caused by cesarean section can be prevented, or at least reduced. Typically, the peritoneum is not repaired after cesarean section. This was originally thought to help reduce the formation of scar tissue.
However, studies illustrate that by surgically repairing the peritoneum after a c-section, you actually decrease your likelihood of developing adhesions by seven fold.
In a study conducted at Stanford University, women who had undergone cesarean sections were analyzed for scar tissue and adhesions.
73% of women who had not had their peritoneum repaired had developed adhesions.
However, only 52% of women who had their peritoneum repaired showed evidence of these adhesions.
If you have had a c-section and are considering having another for a subsequent pregnancy, speak with your health care provider about whether a VBAC or another cesarean section would be the best option for you.