Spikes after caesarean section: signs and prevention

Pregnancy and the birth of a child are the most beautiful and happy period in a woman's life. But not all of it is cloudless. Someone may have problems with bearing a fetus, and others after the expiration of pregnancy face the fact that they can not give birth on their own, as a result of which doctors have to resort to an operation called cesarean section. But on this all the troubles do not end. A frequent problem is the spikes after cesarean section, which subsequently noticeably cloud the joy associated with the birth of a new life.

What are spikes?

Spikes after caesarean section are nothing more than a scar tissue formed on the site of the "work" of the surgeon's scalpel. By the way, the formation of adhesions is characteristic not only of caesarean section. The appearance of adhesions on the body is a normal physiological process that develops after any cavitary operations and is one of the most common complications after cesarean section.

The formation of adhesions, according to doctors, is associated with the protective functions of the body. Thus, he protects himself from getting the infection inside and spreading it in the abdominal cavity through open wounds, resulting from a violation during the operation of the integrity of various tissues and organs. It is the protective reaction of the organism that underlies the pathogenesis of the development of the adhesion process.

On the scars, there is never a development of purulent-inflammatory processes. They (spikes) protect against this fate and the entire abdominal cavity. And all would be nothing if these same spikes were not the cause of the fusion of the intestinal loops with nearby organs, which can subsequently significantly complicate the life of the newly minted mother.

Causes of the adhesions after caesarean section

If you think carefully, then nothing in our boundless world appears just like that. There is a reason for everything. So in the case of the formation of adhesions after cesarean section. Their appearance was promoted by some reasons, in time having excluded which, it is possible to avoid unpleasant consequences.

Doctors are inclined to believe that the main and most common reason for the formation of adhesions after cesarean section is still the insufficient physical activity of women after the operation. The sedentary lifestyle of young mothers can be due to the fact that the body often slowly enough to recover after a difficult birth. The fear of discrepancy in postoperative sutures, soreness in the lower abdomen with active movements, and vegetative disorders due to hormonal imbalance that arose during pregnancy also contribute to the limitation of activity.

The formation of adhesions and gluing of the abdominal cavity organs can provoke inflammatory processes in the peritoneum. With cesarean section, the formation of adhesions is noted just in the region of the small pelvis, where "inflammation" foci often "nest".

The appearance of adhesions is sometimes the result of an incorrect operation of the caesarean section itself. Then the fault is the lack of professionalism of the surgeon or negligence on the part of assistants and medical staff. Inaccurate seam or "accidentally" forgotten in the abdominal cavity inventory also become a fairly frequent and serious cause of the development of adhesive process.

In principle, both the inactive way of life, and the development of inflammatory processes in the pelvic organs, and the incompetence of the personnel performing surgical intervention are only risk factors for the appearance of adhesions in the postoperative period, which can be avoided if one takes one's health (and the health of others ) more attentively.

[1], [2], [3], [4]

Pathogenesis

Spikes are the formations from the connective tissue of the body. Their formation can be diagnosed already in the first 12 hours after surgery performed on the abdominal cavity. This is due to the release during 3 consecutive days of wound exudate containing various cellular structures and a liquid fraction of blood containing fibrinogen (a colorless protein in the blood plasma produced by the liver). It is from the latter that threads are formed that lie on the surface of the peritoneum and organs within the abdominal cavity.

Fibrinogen stimulates the production of fibroblasts, which in turn synthesize collagen, which is the basis of adhesive tissue. The formation of adhesions is coming to an end within the next 2-4 weeks.

Inflammatory processes in turn also actively participate in the formation of adhesive tissue. After all, not only leukocytes are involved in the process of inflammation, but also many other cells, among which the above-mentioned fibroblasts can be distinguished with their ability to stimulate the processes of polypletion and tissue regeneration. Thus, all conditions are created for the appearance of scar formation from the connective tissue.

According to statistics, the most common are spiky on the ovaries after cesarean section. An increase in the number of cases of their formation is promoted by a rapid increase in the number of inflammatory diseases of the ovaries, in particular of an infectious nature. Diagnosing them is not always possible on time, and women are not in a hurry to run with this problem to the gynecologist, without thinking that this unjustifiably expose themselves to the risk of developing pathologies leading to infertility.

As to the reasons why spikes after caesarean section can be formed, the first place in the "popularity rating" can be attributed to the surgical intervention and its consequences, and various inflammatory processes will take the "honorable" second place.

[5], [6]

Symptoms of the adhesions after caesarean section

Despite the fact that spikes are starting to form in the first hours after the operation, most women do not suspect their existence for a long time. Especially this applies to adhesions after cesarean section, because newly mums sometimes have time to look up into the mountain, not to listen to their sensations. All thoughts of women in the postpartum period are aimed precisely at their precious baby, displacing the faces of their health.

The first signs of the formation of adhesions are unpleasant pains, localized mainly in the lower abdomen. Pain during adhesions after caesarean section differs from similar symptoms in peritonitis or inflammation of the cecum (appendicitis). They have a pulling character. Sometimes they are accompanied by a feeling of raspiraniya, as with swelling of the intestine. These symptoms, like excessive gas formation, are most often referred to as malnutrition or to the use of stale foods.

The situation is aggravated by the emerging problems with a stool, which becomes either frequent and liquid (diarrhea), or is performed rarely and with difficulty (constipation). The woman is even more convinced that the cause of all the pathologies of the gastrointestinal tract, often appearing against the background of pregnancy, as one of the complications, without even suspecting the growth of connective tissue at the site of the previous birth operation.

If the spikes after caesarean section were formed on the ovaries, the pains in the lower abdomen are dull, without distinctive intensity. They are characterized by enviable constancy with localization on one side of the abdomen, in connection with which women take such pains for the long process of healing of the postoperative suture. Pain intensifies only during menstruation, which does not happen in nursing mothers soon.

Sometimes the pain sensations spread to the lower back, accompanied by a feeling of heaviness in it.

But the pain syndrome is not an obligatory symptom of the developing adhesion process. Most often, the formation of adhesions occurs without significant symptoms. Gas formation and constipation is written off for intestinal obstruction, without delving into the causes of its appearance, and diarrhea is referred to the symptoms of food poisoning or again associated with the consequences of temporary intestinal obstruction.

The question is raised when multiple attempts to become pregnant for the second or third time remain unanswered by the female body. It is here that the consequences of an operation once carried out are revealed. It turns out that spikes complicate the release of the egg from the ovary, preventing full ovulation and fertilization of the ovum, or provoke obstruction of the fallopian tubes due to the development of the inflammatory process, or they alter the structure of the reproductive organs themselves.

All this is accompanied by irregularities in the menstrual cycle, decreased performance, constant weakness, scanty discharge of greenish or yellow, sometimes with bloody veins. Body temperature can rise to subfebrile values (37-38 degrees) and stay so for a very long time, indicating a developing pathological process. Such symptoms can not be ignored, because they entail, among other things, the violation of the reproductive function of the female body.

Pain after spasms after cesarean section and pathological discharge may increase with psychoemotional and physical exertion, increased activity and lifting of heavy objects, during intercourse and during supercooling of the pelvic and lumbar region, with menstruation and at the time of ovulation, with a full bladder and at the moment defecation during bowel evacuation. On this, too, should pay attention in connection with the probability of formation of adhesions after cesarean section.

[7], [8], [9], [10]

Stages

It is impossible to determine the stage of development of adhesive process by eye. Such information can be obtained only at the time of diagnostic studies from laparoscopy data.

The stage of spreading of the commissural disease is determined on the basis of the severity of the pathological changes in the work of the organs involved in this process.

So, the first stage of adhesive process is characterized by the location of adhesions after caesarean section around the organs of reproduction (the fallopian tube and ovaries) or other organs located in the abdominal cavity, but do not affect their functioning.

At the second stage of the process of formation of adhesions on the scars after caesarean section, their spread between one of the ovaries and the fallopian tube is noted, including other organs of the small pelvis, which may prevent the egg from entering into the fallopian tube.

The third stage of adhesion is characterized by the development of infertility. Spikes entangle the fallopian tube, causing its obstruction, and completely block the capture of the egg.

[11]

Forms

There are also 3 types of development of adhesions after surgery. More precisely, we are talking about the forms in which a disease characterized by the formation of adhesions after cesarean section can occur.

For the acute form of the adhesive process, the symptoms of intestinal obstruction are characteristic (acute and cramping pains in the abdomen, nausea and vomiting, stool disorder), accompanied by fever elevation to 38-39 degrees and heart rate (pulse), weakness, fall in blood pressure, intoxication .

The intermittent form of the course of adhesion is more common than acute. It is characterized by almost the same symptoms, but their intensity is much weaker. To a greater extent, for this reason, the pathology remains unnoticed, and the malaise is written off for problems with the intestine (the symptoms of intestinal obstruction are more pronounced than others).

For the chronic form of adhesive process, the "norm" is the absence of any unpleasant symptoms. Occasionally, an adhesion can remind oneself of weak pulling pains in the lower abdomen, digestion disorders in the form of periodically appearing constipation or diarrhea, weight loss without any prerequisites for this.

[12], [13], [14]

Complications and consequences

The question of the consequences of the development of the adhesion process after a caesarean section operation remains open, since the answer to it depends on many factors. For example, the age of the patient, the form in which the disease occurs, the degree of distribution of the number and size of adhesions.

In themselves, spikes are benign entities and do not pose any danger to health, unless their formation does not affect the work of other organs.

The most common complication that can cause spasms after caesarean section is a decrease in bowel perelstatics and the development of intestinal obstruction leading to poisoning of the body with toxins formed during stagnation of food in the intestine.

A significant increase in temperature in the acute form of the course of adhesions and the need to actively move, caring for the baby, can give complications to the cardiovascular system, cause the development of tachycardia and arterial hypotension.

But the most terrible for women of childbearing age is the diagnosis of "infertility." But one of the most common causes of infertility in young women is the formation of adhesions on the ovaries or in the area of the uterine tube after a previous operation of caesarean section, limiting the movement of the egg in the ovary and its capture by the fallopian tube.

If we talk about the dangerous consequences of the formation of adhesions, then they can include the development of secondary infertility, which occurs against the background of an ectopic pregnancy. If the formation of adhesions affects the ovaries and uterus with fallopian tubes, an unforeseen situation may arise. When the egg, flying into the fallopian tube, after a fruitful meeting with the "selected" sperm can not get to the destination (in the uterus) due to obstruction of the uterine tube caused by the spreading of the adhesive process to this area, the development of pregnancy occurs outside the uterus. And this state is dangerous not only for health and fertility, but also for the life of the woman herself.

What is the probability of developing an ectopic pregnancy or infertility, it is impossible to answer, until the degree of spreading of the adhesive process is established. On the question of whether it is possible to become pregnant with spikes after cesarean section, there is no definitive answer either. One thing is for sure that spikes after cesarean section are not a verdict. Effective treatment, often implying and re-operative intervention, most often allows to restore patency of the fallopian tubes. Another thing, if the adhesive process caused the violation of the functions of the reproductive organs, resulting in infertility. The most important thing is not to allow a wide spread of the process, and in the event of the formation of a large number of adhesions, take measures to neutralize them as soon as possible.

[15], [16], [17],

Diagnostics of the adhesions after caesarean section

There are 2 main variants of the development of events. Either the formation of adhesions after cesarean section occurs with the characteristic symptomatology of the process, and the woman herself comes to the women's consultation for help, or the adhesion does not make itself felt, and her consequences are revealed when the question arises of the impossibility of conception.

There is also the third variant, when pathological proliferation of connective tissue in the abdominal cavity is detected as a result of preventive gynecological examination, most often in connection with other diseases of the genital area. Yes, only regular examination for a gynecologist for various reasons is almost the biggest problem for most women, especially for young mothers who are absorbed in caring for their baby.

And the sooner the formation of adhesions on internal organs is revealed, the more effective will be the treatment of pathology, and the probability of infertility is less likely, which is especially important for young women who dream of becoming a mother more than once.

The appearance after the caesarean section of symptoms of intestinal obstruction, which had not previously been observed, should already serve as an alarm signal, and a woman can hear it without the help of a specialist. Doctors, in turn, also need to take a survey of women who have undergone a cavitary operation, with special attention, with any pathologies, not excluding the parallel development of adhesions.

[18], [19]

Analyzes

Specific analyzes to identify adhesions after a previous cesarean section are not carried out. Nevertheless, traditional laboratory tests of blood and smears from the vagina will allow the doctor to draw a complete picture of the health of the sexual sphere of a woman. At the same time, it becomes possible to identify hidden infectious and inflammatory processes, to identify the causative agent of infection, and even to diagnose such a dangerous pathology as dysplasia (as a result of a histological examination of the smear) in time to begin their treatment in parallel with manipulations to neutralize the adverse effects of adhesions.

[20], [21], [22], [23]

Instrumental research

Instrumental diagnostics makes it possible to supplement the picture of the disease, but not all of its methods are effective enough. For example, ultrasound and MRI of pelvic organs allow to determine the exact location of neoplasms, but can not exactly answer the question: are they spikes or something else.

Electrogastroenterography gives a complete picture of how the gastrointestinal tract works, but does not help to pinpoint the cause of the intestinal obstruction. The pelvic examination of the pelvic organs helps to detect the presence of an inflammatory exudate in the abdominal cavity, which is the cause of the formation of adhesions after cesarean section, and also to determine whether the formation of gas is increased and whether there is swelling of the intestine.

To determine abnormalities in the operation of the fallopian tubes and ovaries in connection with the possible development of a commissural disease, the method of hysterosalpingography is used, which makes it possible to see pathological changes in the structure of the organs and their work, and also to determine the stage of development of the adhesion process.

But the most complete and accurate information about the problem can be obtained only from the results of laparoscopy. This is not only an effective method of instrumental diagnostics that allows you to visually determine with great accuracy the presence of adhesions and their location, estimate their size, determine the stage of adhesions, but also micro-operation (in small incisions special equipment with a camera is introduced) urgent treatment of pathology.

Differential diagnosis

For the conduct of differential diagnosis, an important role is played by the collection of anamnesis of the patient, examination of her complaints and external examination, including palpation of the abdomen. The fact is that the examination on the armchair with the use of mirrors can not tell anything about the problem, but with palpation you can find a violation of the uterine mobility or the presence of an infiltrate (a seal indicating the formation of rather large adhesions) in the ovaries and fallopian tubes.

It is very important to clarify the patient whether she had previous surgical operations in the pelvic area, how regular and painful menstruation is, whether there are pains during intercourse, where soreness is felt, what the nature of the pains and other questions help to clarify the diagnosis .

Treatment of the adhesions after caesarean section

Treatment of adhesions can be carried out in two ways: help in resolving adhesions and removing unpleasant symptoms or re-surgery to remove adhesions and prevent relapses. Conservative treatment includes the use of medications and methods of physiotherapy.

Among the medications used for spasms after cesarean section, 4 groups of drugs are distinguished:

• Preparations that promote resorption of adhesions, due to the dissolution of fibrin (fibrinolytic agents: "Fibrinolysin", "Streptokinase", "Trypsin", "Himopsin", "Longidase", "Alteplase", "Aktilise", etc.)
• Means for antimicrobial therapy (antibiotics: "Tetracycline", "Cefazolin", "Vilprafen", sulfonamides, for example, "Ftalazol", etc.)
•  Drugs that reduce blood coagulability (anticoagulants: "Heparin Ointment", "Cleavin", "Wafarin", etc.)
• Medicines that remove inflammatory processes in the pelvic region (anti-inflammatory drugs: corticosteroids, NSAIDs, calcium channel blockers, etc.).

Sometimes in the complex treatment as a fortifying agent, vitamins can be prescribed, although they do not carry a weighty role in the fight against adhesions.

When it comes to postoperative adhesions, preparations of the 1st group come to the fore, other preparations are prescribed if necessary, if the inflammatory process is in parallel with the adhesive.

"Fibrinolysin" has the ability to break down protein strands of fibrin, so that the adhesions become more friable and eventually dissolve completely.

Dosing and Administration: is administered by means of a dropper in combination with sodium chloride and heparin. Dosage of 100-200 units per 1 ml of water for injection. The dose of "Heparin" is 2 times less than "Fibrolizin".

Treatment with the drug is carried out under strict control of blood coagulability.

Side effects of the drug a little: allergic reactions, lowering blood pressure, abdominal pain and injection site, bleeding. But there are enough contra-indications, among them: pregnancy, a tendency to bleeding, hepatitis, breast-feeding, peptic ulcer lesions, liver damage, etc. You can apply the drug not earlier than 10 days after the operation.

"Trypsin" is one of the most commonly used drugs with a prothiolytic effect. It belongs to the class of enzyme preparations capable of cleaving the viscous wound exudate and fibrinous formations, which are the spikes after the caesarean section.

In connection with this problem, the drug is used in the form of intramuscular injections or locally, using a ready-made solution for wetting tampons, which are then injected into the vagina. The tampon is put on for a couple of hours. It is better to do it in the evening. Dosage for intravenous injections is 5-10 mg. The powder is diluted in a solution of sodium chloride or procaine. The injections are done 1 or 2 times a day by a course of 6 to 15 injections.

Reception of the drug may be accompanied by an increase in heart rate, heat, allergic manifestations, pain and redness at the site of administration of the drug. The drug is not used to treat patients with severe liver, kidney and lung diseases, heart failure, pancreatitis. And also in case of hypersensitivity to the drug.

"Chemopsin" is an enzyme preparation for external use, which when applied to body tissues helps to remove purulent masses from wounds and resorption of fibrinous formations, including postoperative adhesions. Good results are obtained on fresh wounds and not overtaken scars as a preventive measure.

Produced in the form of a powder, which before use is mixed with a solution of procaine or sodium chloride (from 25 to 50 mg of powder per 10-50 ml of solution). The finished solution is impregnated with napkins and applied to the postoperative suture for 2-4 hours.

Side effects of the drug is small: a slight increase in temperature or local allergic manifestations. It is not applied in the presence of cancerous tumors, severe heart failure, ulcers on the skin and bleeding wounds.

"Longidase" - no less popular drug than "Trypsin". It is convenient for use with spikes on the reproductive organs, which is often after a caesarean section, because it is available in the form of suppositories and powder for the preparation of a drug solution. The indications for use explicitly state that it is intended for the prevention and treatment of adhesions in the small pelvis.

Powder, as in previous cases, is bred in sodium chloride or procaine. Dosage for treatment of adhesions in the pelvis is 3000 ME. Injections are done intramuscularly once every few days (the interval between injections is 3 to 5 days). Therapeutic course of 10 to 15 injections.

For greater effect in parallel with injections, treatment with candles recommended for insertion into the anus or vagina is recommended. Introduce the suppository should be 1 time in 3 days course in 10 suppositories.

Of the side effects related to both forms of the drug, you can identify only a rare allergic reactions. With intramuscular administration, pain and redness at the injection site can be observed.

The drug has few contraindications to use. This pregnancy, malignant tumors, hypersensitivity to the components of the drug. For the / m introduction of the drug slightly more restrictions: acute infectious diseases, bleeding (pulmonary and eye), kidney failure.

In parallel with the reception of effective medicines in each case, physiotherapy sessions are held. Physiotherapeutic treatment in this case includes electrophoresis procedures with hyaluronidase, lidase and other specific enzyme preparations, electrostimulation of tissues, paraffin applications, mud therapy, magnetic therapy in combination with therapeutic massage and special exercises, effective for adhesions.

Alternative treatment of adhesions after caesarean section

We will tell directly, it is hardly possible to get rid of adhesions on internal organs only with the help of prescriptions of alternative medicine. Alternative treatment, effective only at the beginning of the pathological process of adhesions (stage 1 of adhesions), can stop the appearance of fibrinous formations by activating blood and lymph circulation, which affects the synthesis and proliferation of connective tissue.

1. The most affordable and effective alternative means decoction of flaxseed. Raw materials for it can be purchased almost at any grocery store. Seeds of flax are boiled in boiling water for about 3-5 minutes, filter. The broth is used for tampons: gauze tightly twisted in the form of a tampon, dipped in a warm broth, squeezed a little and inserted into the vagina. The procedure is done at night for a week. Efficient means for adhesions on the ovaries and fallopian tubes.
2. If flaxseed is brewed in gauze, then the broth can be used for tampons, and slightly squeezed out the seed on a piece of gauze, in which it was cooked, and applied as compresses on the stomach in the place where the spikes are supposedly located. Procedures should be done every 3-4 days. The course of treatment is 1 month.
3. For tampons and syringings, you can use the infusion of root of the bucket. For infusion, take 30 g of crushed root and pour 175 g of water, the temperature of which should be equal to 60 degrees. After 8 hours, the infusion is ready. The course of treatment is 1 month.
4. As an analog of drug treatment through enzymes in alternative medicine, human saliva therapy is used - one of the most powerful enzyme drugs. Spikes after caesarean section can not resist if the postoperative scars are abundantly lubricated with morning saliva.

With adhesions, some progress can be made by practicing herbal treatment. Among the effective in this regard, herbs can be identified with St. John's wort, sage, sabelnik, seeds of milk thistle and plantain, marin root, aloe. They make infusions, tinctures of alcohol and decoctions, which are taken orally, used for douches or for external use. A good effect is provided by infusions from herbal doses, which are consumed internally in combination with traditional medicamentous and physiotherapeutic treatment. Such treatment will help to cope with the disease and prevent relapses, which is not always under the power of surgical treatment.

[24],

Homeopathy in Combating Adhesive Disease

Homeopathy can also make a significant contribution to the treatment of adhesions after caesarean section thanks to effective natural remedies such as Silicea, Fluoricum acidum, Calcarea fluorica, Graphites, Sanguinarinum nitricum.

The first 2 drugs are considered the most effective in terms of resorption adhesions. Positive dynamics in patients after cesarean section is observed even in neglected cases with chronic scars. Both preparations are natural inorganic compounds in the form of homeopathic granules, which take 7 pieces at a time. The granules are held under the tongue until they completely dissolve. Multiplicity of reception Silicea - 3 times a day, Acidum fluoride - 2 times a day.

Calcium fluoride is also an effective tool for postoperative adhesions, but if possible, your choice should be stopped on the first two drugs, the joint administration of which gives very good results, helping to avoid surgery and postoperative complications.

Another inorganic agent of homeopathy Graphite is especially effective at the initial stage of the formation of adhesions, when an exudate accumulates in the abdominal cavity. In the form of a solution, the drug is applied three times a day for 10 drops.

At the very beginning of the treatment of relapses of the commissural disease it is recommended to take drugs together in 6 dilutions of Graphite (5 granules in the morning) and Silicea (5 pellets in the evening) for a long time.

A herbal homeopathic preparation "Sanguinarikum nitrikum" in 6 dilutions helps to say goodbye to annoying pulling pains in the lower abdomen, the cause of which are ill-fated adhesions after cesarean section. Take it in the morning and evening for 5 pellets.

Homeopathic preparations are good because they have practically no contraindications, and their side effects are limited to allergic manifestations against the background of intolerance of individual components of the drug.

Operative treatment

In the first stage of a commissural disease, surgical intervention is usually not required, which can not be said about the second and third stages. Here one medicines and physiotherapy are indispensable. If the adhesions interfere with the normal operation of internal organs, the task of clearing the intestines, ovaries, uterus, etc., comes to the fore. And the restoration of their normal functioning by a re-surgical operation.

In both diagnosis and treatment, the most effective and less traumatic method is laparoscopy. During the diagnostic examination, you can immediately carry out the separation and excision of the adhesive "spider web", as it is represented by women, exhausted by pain and discomfort.

Currently, surgical manipulations for the release of entangled and "stuck together" organs are carried out by 3 methods:

• through the laser (laser therapy),
• using water pressure (aqua dissection),
• with the help of an elektronozha (electrosurgery).

The best effect in terms of preventing relapses of adhesions is surgical treatment with a laser, but the surgeon's scalpel is practically not used to "neutralize" adhesions after cesarean section.

To prevent recurrences of the disease and prevent the formation of new adhesions as a result of a new operation, these methods of prevention are used:

• the introduction into the abdominal cavity of barrier liquids that prevent the appearance of exudate and the formation of fibrinous tissue,
• use self-absorbable films to envelop them with the internal organs of the small pelvis, near the postoperative scars.

It is very good, if surgical treatment is supplemented by drug therapy of anti-inflammatory and proteolytic plan.

Prevention

Prevention of the formation of adhesions after cesarean section should begin immediately upon return from the hospital. Strongly active is not worth not to disturb the postoperative sutures, but to move to the best of your strength you still need, especially since this requires even the usual care of your beloved and the usual duties around the house.

Preventative examination at the gynecologist after some time after operation of cesarean section will help prevent the development and spreading of the adhesive process. A careful attitude to your health will not let you lose the first signs of pathological proliferation of connective tissue, and all unpleasant and suspicious symptoms should be notified by the doctor watching you to stop the adhesion process in time.

It is very important not to start and emerging for various reasons, infectious and inflammatory processes in the pelvic region that promote the formation of adhesions.

[25], [26], [27]

Forecast

The prognosis of a commissural disease that has arisen after surgery (caesarean section, abortions, abdominal surgery) is less favorable than in the case of the formation of fibrinous tissue against the background of inflammatory processes. Nevertheless, early treatment for help will help to avoid unpleasant consequences. Even in the second stage of the disease there are good chances to solve the problem positively.

If the process is started, then even surgical treatment may not have a positive effect. If the pain and the spikes themselves somehow managed to cope, then the problem of infertility in this problem is not always possible.

True, spikes after Caesarean section at present can not be an obstacle for those who once again dreams of knowing the joy of motherhood. In the end, there are IVF and other ways to give birth to a child on their own. In extreme cases, you can resort to the services of a surrogate mother. But if a woman has a big heart and a kind soul, not being able to give birth to her child, she is able to surround with love and care of a child left without parental care, which is no less valuable than the birth of a new life.

[28], [29], [30], [31]