Adhesions after cesarean section: signs and prevention

Pregnancy and childbirth are the most wonderful and happy periods in a woman's life. But not everyone experiences it without a cloud. Some may have problems with bearing the fetus, while others, after the pregnancy has expired, are faced with the fact that they cannot give birth on their own, as a result of which doctors have to resort to an operation called a cesarean section. But this is not the end of all the troubles. A common problem is adhesions after a cesarean section, which subsequently significantly darken the joy associated with the birth of a new life.

What are adhesions?

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

The formation of adhesions, according to doctors, is associated with the protective functions of the body. In this way, it protects itself from infection getting inside and spreading it in the abdominal cavity through open wounds formed as a result of the violation of the integrity of various tissues and organs during surgery. It is the protective reaction of the body that underlies the pathogenesis of the development of the adhesion process.

The development of purulent-inflammatory processes is never noted on the scars themselves. They (adhesions) protect the entire abdominal cavity from such a fate. And everything would be fine if these same adhesions were not the cause of the fusion of intestinal loops with nearby organs, which can subsequently significantly complicate the life of a new mother.

Causes adhesions from a cesarean section

If you think about it, nothing in our boundless world just appears. Everything has its own reason. The same is true for the formation of adhesions after a cesarean section. There are several reasons that contribute to their appearance, and if you eliminate them in time, you can avoid unpleasant consequences.

Doctors are inclined to believe that the main and most common cause of adhesions after a cesarean section is still insufficient physical activity of women after the operation. A sedentary lifestyle of young mothers may be due to the fact that the body often recovers quite slowly after a difficult birth. The limitation of activity is also facilitated by the fear of divergence of postoperative sutures, pain in the lower abdomen with active movements, vegetative disorders due to hormonal imbalance that occurred during pregnancy.

Formation of adhesions and gluing of abdominal organs can provoke inflammatory processes in the peritoneum. In case of cesarean section, formation of adhesions is observed precisely in the pelvic area, where inflammation foci often “nest”.

The appearance of adhesions is sometimes a consequence of improper performance of the cesarean section operation itself. Then the fault lies with the lack of professionalism of the surgeon or negligent actions on the part of assistants and medical personnel. A sloppy suture or equipment “accidentally” forgotten in the abdominal cavity also become a fairly frequent and serious cause of the development of the adhesion process.

In principle, a sedentary lifestyle, the development of inflammatory processes in the pelvic organs, and the incompetence of the personnel performing the surgical intervention are all just risk factors for the appearance of adhesions in the postoperative period, which can be avoided if you take a more careful approach to your health (and the health of other people).

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Pathogenesis

Adhesions are formations of connective tissue in 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 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) during the 3 days following the operation. It is from the latter that the threads are formed that lie on the surface of the peritoneum and organs inside the abdominal cavity.

Fibrinogen stimulates the production of fibroblasts, which in turn synthesize collagen, which is the basis of adhesion tissue. The formation of adhesions is completed within the next 2-4 weeks.

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

According to statistics, the most common are adhesions on the ovaries after a cesarean section. The increase in the number of cases of their formation is facilitated by the rapid growth in the number of inflammatory diseases of the ovaries, in particular of an infectious nature. It is not always possible to diagnose them in time, and women are in no hurry to run to the gynecologist with this problem, without thinking about the fact that they unjustifiably expose themselves to the risk of developing pathologies leading to infertility.

As for the reasons why adhesions may form after a cesarean section, the first place in the “popularity rating” can be given to the surgical intervention and its consequences, and various inflammatory processes will take the “honorable” second place.

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Symptoms adhesions from a cesarean section

Despite the fact that adhesions begin to form in the first hours after the operation, most women do not suspect their existence for a long time. This is especially true for adhesions after a cesarean section, because new mothers sometimes have no time to look up at the mountain, let alone listen to their feelings. All thoughts of women in the postpartum period are aimed specifically at their precious baby, displacing concerns about their health.

The first signs of adhesions are considered to be unpleasant pains, localized mainly in the lower abdomen. Pains with adhesions after a cesarean section differ from similar symptoms with peritonitis or inflammation of the cecum (appendicitis). They are of a pulling nature. Sometimes they are accompanied by a feeling of distension, as with intestinal bloating. These symptoms, like excessive gas formation, are most often attributed to improper nutrition or the use of stale foods.

The situation is aggravated by problems with stool, which becomes either frequent and liquid (diarrhea), or rare and difficult (constipation). The woman becomes even more convinced that the culprit is gastrointestinal pathologies, which often appear during pregnancy as one of the complications, without even suspecting the growth of connective tissue at the site of the previous birth operation.

If adhesions after a cesarean section have formed on the ovaries, the pain in the lower abdomen is dull in nature, not particularly intense. They are characterized by enviable constancy with localization on one side of the abdomen, due to which women take such pain for a long healing process of the postoperative suture. The pain intensifies only during menstruation, which does not happen soon for nursing mothers.

Sometimes the pain spreads to the lumbar region, accompanied by a feeling of heaviness in it.

But pain syndrome is not a mandatory symptom of the developing adhesive process. Most often, the formation of adhesions occurs without pronounced symptoms. Gas formation and constipation are attributed to intestinal obstruction, without going into the reasons for its occurrence, and diarrhea is attributed to the symptoms of food poisoning or, again, is associated with the consequences of temporary intestinal obstruction.

The question is put bluntly when multiple attempts to get pregnant for the second or third time remain unanswered by the female body. This is where the consequences of the operation that was once undergone are revealed. It turns out that adhesions make it difficult for the egg to leave the ovary, preventing full ovulation and fertilization of the egg, or provoke obstruction of the fallopian tubes due to the development of an inflammatory process, or change the structure of the reproductive organs themselves.

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

Pain in adhesions after a cesarean section and pathological discharge may increase with psycho-emotional and physical stress, increased activity and lifting heavy objects, during sexual intercourse and with hypothermia of the pelvic and lumbar region, during menstruation and at the time of ovulation, with an overflowing bladder and at the time of defecation when emptying the intestines. This is also worth paying attention to in connection with the likelihood of adhesions forming after a cesarean section.

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Stages

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

The stage of spread of adhesive disease is determined based on the severity of pathological changes in the functioning of the organs involved in this process.

Thus, stage I of the adhesive process is characterized by the location of adhesions after a cesarean section around the reproductive organs (fallopian tubes and ovaries) or other organs located in the abdominal cavity, but do not affect their functioning.

At stage II of the process of adhesion formation on the scars after a cesarean section, their spread is noted between one of the ovaries and the fallopian tube, including other organs of the small pelvis, which can prevent the release of the egg into the fallopian tube.

Stage III of adhesive disease is characterized by the development of infertility. Adhesions entangle the fallopian tube, causing its obstruction, and completely block the capture of the egg.

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Forms

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

The acute form of the adhesive process is characterized by severe symptoms of intestinal obstruction (sharp and cramping abdominal pain, nausea and vomiting, bowel disturbances), accompanied by an increase in temperature to 38-39 degrees and heart rate (pulse), weakness, a drop in blood pressure, and signs of intoxication.

The intermittent form of the course of adhesive disease is more common than the acute one. It is characterized by almost the same symptoms, but their intensity is much weaker. To a large extent for this reason, the pathology remains unnoticed, and the malaise is attributed to problems with the intestines (the symptoms of intestinal obstruction are expressed more clearly than others).

For the chronic form of the adhesive process, the "norm" is the absence of any unpleasant symptoms. Occasionally, adhesive disease can remind of itself with weak nagging pains in the lower abdomen, digestive disorders in the form of periodically appearing constipation or diarrhea, weight loss without any prerequisites for this.

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Complications and consequences

The question of the consequences of the development of adhesions after a cesarean section remains open, since the answer to it depends on many factors. For example, on the patient's age, the form in which the disease occurs, the extent of the spread of the number and size of adhesions.

Adhesions themselves are benign formations and do not pose any danger to health, unless their formation affects the functioning of other organs.

The most common complication that adhesions after a cesarean section can cause is a decrease in intestinal peristalsis and the development of intestinal obstruction, leading to poisoning of the body with toxins formed during stagnation of food in the intestines.

A significant increase in temperature during the acute form of adhesive disease and the need to move actively while caring for the baby can cause complications in the cardiovascular system, causing the development of tachycardia and arterial hypotension.

But the most terrible thing 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 fallopian tube after a cesarean section, which limit the movement of the egg in the ovary and its capture by the fallopian tube.

If we talk about the dangerous consequences of adhesion formation, they 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 an egg, flying into the fallopian tube, after a fruitful meeting with the "chosen" sperm, cannot get to its destination (the uterus) due to the obstruction of the fallopian tube caused by the spread of the adhesion process to this area, the development of pregnancy occurs outside the uterus. And such a condition is dangerous not only for health and the ability to conceive, but also for the life of the woman herself.

It is impossible to answer the probability of developing an ectopic pregnancy or infertility until the extent of the adhesion process is determined. There is also no clear answer to the question of whether it is possible to get pregnant with adhesions after a cesarean section. One thing can be said for sure, adhesions after a cesarean section are not a death sentence. Effective treatment, which often involves repeated surgery, most often allows restoring the patency of the fallopian tubes. It is another matter if the adhesion process has caused a disruption in the functions of the reproductive organs, resulting in infertility. The most important thing is to prevent the process from spreading widely, and in the event of a large number of adhesions, take measures to neutralize them as quickly as possible.

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Diagnostics adhesions from a cesarean section

There are two main scenarios here. Either the formation of adhesions after a cesarean section occurs with the symptoms typical of this process, and the woman herself comes to the antenatal clinic for help, or the adhesive disease does not make itself known in any way, and its consequences are discovered when the question of the impossibility of conception arises.

There is also a third option, when pathological proliferation of connective tissue in the abdominal cavity is detected as a result of a preventive gynecological examination, most often in connection with other diseases of the genital area. But regular examination by a gynecologist, due to various reasons, is almost the biggest problem for most women, especially for young mothers immersed in caring for their baby.

But the sooner the formation of adhesions on internal organs is detected, the more productive the treatment of the pathology will be, and the less likely it is that infertility will occur, which is especially important for young women who dream of becoming a mother more than once.

The appearance of symptoms of intestinal obstruction after a cesarean section, which were not observed before, 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 treat the examination of women who have undergone abdominal surgery with special attention, in any pathologies not excluding the parallel development of adhesive disease.

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Tests

Specific tests to detect adhesions after a cesarean section are not performed. However, traditional laboratory tests of blood and a vaginal smear will allow the doctor to draw a complete picture of the health of the woman's genital area. This makes it possible to detect hidden infectious and inflammatory processes, determine the causative agent of the infection, and even diagnose such a dangerous pathology as dysplasia (as a result of a histological examination of the smear), in order to begin their treatment in time in parallel with manipulations to neutralize the negative effects of adhesions.

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Instrumental research

Instrumental diagnostics can complete the picture of the disease, but not all of its methods are effective enough. For example, ultrasound and MRI of the pelvic organs can determine the exact location of neoplasms, but cannot accurately answer the question: are these adhesions or something else.

Electrogastroenterography gives a complete picture of how the gastrointestinal tract works, but does not help to accurately determine the cause of intestinal obstruction. X-ray of the pelvic organs helps to identify the presence of inflammatory exudate in the abdominal cavity, which is the cause of adhesions after cesarean section, and also to determine whether gas formation is increased and whether there is bloating.

To determine disturbances in the functioning of the fallopian tubes and ovaries in connection with the probable development of adhesive disease, the hysterosalpingography method is used, which makes it possible to see pathological changes in the structure of organs and their functioning, as well as to determine the stage of development of the adhesive process.

But the most complete and accurate information about the problem can only be obtained from the results of laparoscopy. This is not only an effective method of instrumental diagnostics, allowing you to visually and with great accuracy determine the presence of adhesions and their location, assess their size, determine the stage of development of adhesive disease, but also a microsurgery (special equipment with a camera is inserted into small incisions), with the help of which you can carry out immediate treatment of the pathology.

Differential diagnosis

For differential diagnostics, collecting the patient's medical history, studying her complaints and external examination, including abdominal palpation, play a major role. The fact is that examination on a chair using mirrors may not tell anything about the problem, but palpation can reveal a violation of uterine mobility or the presence of an infiltrate (a compaction indicating the formation of fairly large adhesions) in the area of the ovaries and fallopian tubes.

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

Treatment adhesions from a cesarean section

Treatment of adhesive disease can be carried out in two directions: assistance in the resorption of adhesions and the removal of unpleasant symptoms or repeated surgical intervention in order to remove adhesions and prevent relapses. Conservative treatment includes the use of medications and physiotherapy methods.

Among the medications used for adhesions after cesarean section, there are 4 groups of drugs:

• Drugs that promote the resorption of adhesions by dissolving fibrin (fibrinolytic agents: Fibrinolysin, Streptokinase, Trypsin, Hymopsin, Longidaza, Alteplase, Actilyse, etc.)
• Antimicrobial agents (antibiotics: Tetracycline, Cefazolin, Vilprafen, sulfonamides, such as Phthalazole, etc.)
• Drugs that reduce blood clotting (anticoagulants: Heparin ointment, Klivarin, Wafarin, etc.)
• Medicines that relieve inflammation in the pelvic area (anti-inflammatory drugs: corticosteroids, NSAIDs, calcium channel blockers, etc.).

Sometimes, as part of a comprehensive treatment, vitamins may be prescribed as general tonics, although they do not play a significant role in the fight against adhesive disease.

When it comes to postoperative adhesions, drugs of group 1 come to the forefront, other drugs are prescribed as needed if there is an inflammatory process in parallel with the adhesion process.

"Fibrinolysin" has the ability to break down the protein threads of fibrin, due to which adhesions become looser and eventually dissolve completely.

Method of administration and dosage: administered via a dropper in combination with sodium chloride and heparin. Dosage 100-200 U per 1 ml of water for injection. The dose of "Heparin" is 2 times less than "Fibrolysin".

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

The drug has few side effects: allergic reactions, decreased blood pressure, abdominal pain and pain at the injection site, bleeding. However, there are enough contraindications, including: pregnancy, bleeding tendency, hepatitis, breastfeeding, ulcerative gastrointestinal lesions, liver damage, etc. The drug can be used no earlier than 10 days after surgery.

"Trypsin" is one of the most commonly used drugs with protiolytic action. It belongs to the class of enzyme drugs capable of breaking down viscous wound exudate and fibrinous formations, which are adhesions after cesarean 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 inserted into the vagina. The tampon is placed for a couple of hours. It is better to do this in the evening. The dosage for intramuscular injections is 5-10 mg. The powder is diluted in a solution of sodium chloride or procaine. Injections are made 1 or 2 times a day in a course of 6 to 15 injections.

Taking the drug may be accompanied by increased heart rate, fever, allergic reactions, pain and redness at the injection site. The drug is not used to treat patients with severe liver, kidney and lung pathologies, heart failure, pancreatitis. And also in case of hypersensitivity to the drug.

"Hymopsin" is an enzyme preparation for external use, which, when applied to body tissues, helps remove purulent masses from wounds and resolve fibrinous formations, including postoperative adhesions. It gives good results on fresh wounds and not old scars as a preventive measure.

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

The drug has few side effects: a slight increase in temperature or local allergic reactions. It is not used in the presence of cancerous tumors, severe heart failure, skin ulcers and bleeding wounds.

"Longidaza" is no less popular than "Trypsin". It is convenient for use in cases of adhesions on the reproductive organs, which often occurs after a cesarean section, since it is available in the form of suppositories and powder for the preparation of a medicinal solution. The indications for use directly indicate that it is intended for the prevention and treatment of adhesions in the pelvis.

The powder, as in the previous cases, is diluted in sodium chloride or procaine. The dosage for the treatment of adhesions in the pelvis is 3000 IU. Injections are given intramuscularly once every few days (the interval between injections is from 3 to 5 days). The therapeutic course is from 10 to 15 injections.

For greater effect, in parallel with injections, it is recommended to carry out treatment with suppositories, which are inserted into the anus or vagina. Suppositories should be inserted once every 3 days in a course of 10 suppositories.

Side effects related to both forms of the drug include only rare allergic reactions. When administered intramuscularly, pain and redness at the injection site may occur.

The drug has few contraindications for use. These are pregnancy, malignant tumors, hypersensitivity to the components of the drug. For intramuscular administration of the drug, there are slightly more restrictions: acute infectious diseases, bleeding (pulmonary and ocular), renal failure.

In parallel with taking effective medications in each specific case, physiotherapy sessions are conducted. Physiotherapeutic treatment in this case includes electrophoresis procedures with hyaluronidase, lidase and other specific enzyme preparations, electrical stimulation of tissues, paraffin applications, mud therapy, magnetic therapy in combination with therapeutic massage and special exercises that are effective in adhesive disease.

Folk treatment of adhesions after cesarean section

Let's be honest, it is unlikely that you will be able to get rid of adhesions on internal organs using only traditional medicine recipes. Traditional treatment, which is effective only at the beginning of the pathological process of adhesion formation (stage 1 of adhesive disease), can stop the appearance of fibrinous formations by activating blood and lymph circulation, which affects the synthesis and growth of connective tissue.

1. The most accessible and effective folk remedy is considered to be a decoction of flaxseed. The raw materials for it can be purchased in almost any grocery store. Flax seeds are boiled in boiling water for about 3-5 minutes, filtered. The decoction is used for tampons: gauze tightly twisted into a tampon shape is dipped in a warm decoction, squeezed out a little and inserted into the vagina. The procedure is done at night for a week. An effective remedy for adhesions on the ovaries and fallopian tubes.
2. If flaxseed is brewed in gauze, the decoction can be used for tampons, and the slightly squeezed seed can be smoothed out on a piece of gauze in which it was boiled, and applied as compresses to the abdomen in the place where adhesions are presumably located. The procedures should be done once every 3-4 days. The course of treatment is 1 month.
3. For tampons and douching, you can also use an infusion of the bergenia root. For the infusion, take 30 g of crushed root and pour 175 g of water, the temperature of which should be 60 degrees. After 8 hours, the infusion is ready. The course of treatment is 1 month.
4. As an analogue of drug treatment with enzymes in folk medicine, therapy with human saliva is used - one of the most powerful enzyme agents. Adhesions after a cesarean section will not be able to withstand if postoperative scars are generously lubricated with morning saliva.

In case of adhesive disease, certain progress can be achieved by practicing herbal treatment. Among the herbs that are effective in this regard are St. John's wort, sage, meadowsweet, milk thistle and plantain seeds, peony root, and aloe. They are used to make infusions, alcohol tinctures, and decoctions that are taken internally, used for douching, or for external use. Infusions of herbal mixtures, which are taken internally in combination with traditional medication and physiotherapy, also have a good effect. Such treatment will help to cope with the disease and prevent relapses, which is not always possible with surgical treatment.

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Homeopathy in the fight against adhesive disease

Homeopathy can also make a significant contribution to the treatment of adhesions after cesarean section through 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 of adhesions. Positive dynamics in patients after cesarean section is observed even in advanced cases with old scars. Both drugs are natural inorganic compounds in the form of homeopathic granules, which are taken 7 pieces at a time. Granules are kept under the tongue until they completely dissolve. The frequency of taking Silicea is 3 times a day, Acidum fluoricum - 2 times a day.

Calcarea fluorica is also an effective remedy for postoperative adhesions, but if possible, you should opt for the first two drugs, the combined use of which gives very good results, helping to avoid surgery and postoperative complications.

Another inorganic homeopathic remedy, Graphite, is especially effective at the initial stage of adhesion formation, when exudate accumulates in the abdominal cavity. In the form of a solution, the drug is used three times a day, 10 drops at a time.

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

And the herbal homeopathic preparation "Sanguinaricum nitricum" in 6 dilutions helps to say goodbye to annoying nagging pains in the lower abdomen, the cause of which are the unfortunate adhesions after a cesarean section. It should be taken in the morning and evening, 5 granules.

The good thing about homeopathic medicines is that they have virtually no contraindications, and their side effects are limited to allergic reactions due to intolerance to individual components of the medicine.

Surgical treatment

At the first stage of adhesive disease, surgical intervention is usually not required, which cannot be said about the second and third stages. Here, medications and physiotherapy alone are not enough. If adhesions interfere with the normal functioning of internal organs, the task of freeing the intestines, ovaries, uterus, etc. and restoring their normal functioning by repeated surgery comes to the fore.

In both diagnostics and treatment, the most effective and least traumatic method is laparoscopy. During the diagnostic examination, it is possible to immediately separate and excise the adhesive "web", as women tormented by pain and discomfort imagine it.

Currently, surgical manipulations to release entangled and “stuck together” organs are carried out using 3 methods:

• by means of a laser (laser therapy),
• using water pressure (aquadissection),
• using an electric knife (electrosurgery).

The best effect in terms of preventing relapses of adhesive disease is surgical treatment with a laser, but the surgeon's scalpel is practically no longer used to "neutralize" adhesions after a cesarean section.

In order to prevent relapses of the disease and prevent the formation of new adhesions as a result of a new operation, the following preventive methods are used:

• introduction of barrier fluids into the abdominal cavity that prevent the appearance of exudate and the formation of fibrinous tissue,
• the use of self-absorbing films to cover the internal organs of the small pelvis, near postoperative scars.

It is very good if surgical treatment is supplemented with drug therapy of an anti-inflammatory and proteolytic nature.

Prevention

Prevention of adhesions after a cesarean section should begin immediately upon returning from the maternity hospital. You should not be too active so as not to disturb the postoperative sutures, but you still need to move as much as you can, especially since this is required even for the usual care of your beloved baby and your usual chores around the house.

A preventive examination by a gynecologist some time after a cesarean section will help prevent the development and spread of the adhesion process. A careful attitude to your health will not allow you to miss the first signs of pathological proliferation of connective tissue, and you should notify your doctor about all unpleasant and suspicious symptoms in order to stop the adhesion process in time.

It is very important not to ignore infectious and inflammatory processes in the pelvic area that arise for various reasons and contribute to the formation of adhesions.

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Forecast

The prognosis for adhesive disease that occurs after surgery (cesarean section, abortion, abdominal surgery) is less favorable than in the case of fibrinous tissue formation due to inflammatory processes. However, early treatment will help avoid unpleasant consequences. Even at the second stage of the disease, there is a good chance of solving the problem positively.

If the process is started, even surgical treatment may not give a positive effect. Even if the pain and the adhesions themselves can be somehow dealt with, it is not always possible to solve the problem of infertility with this problem.

True, adhesions after a cesarean section cannot currently be an obstacle for those who dream of experiencing the joy of motherhood once again. After all, there is IVF and other ways to give birth to a child on your 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, without the opportunity to give birth to her own child, she is able to surround a baby left without parental care with love and care, which is no less valuable than the birth of a new life.

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