Modern possibilities of prevention and diagnosis of adhesive disease in patients after caesarian section

This article discusses the relevance of adhesive disease after caesarian section due to the increase in the frequency of repeated operative delivery and the increasing risk of complications during both pregnancy and surgery. The modern understanding of the pathogenesis of the adhesive process is highlighted in the article. It has been shown that in response to a peritoneal injury, a local inflammatory process is activated and local activation of the coagulation system occurs. In this case, the first few days of the postoperative period are extremely important, as mature fibrous adhesions are subsequently formed, and adhesion formation becomes irreversible. The effectiveness of surgical, physiotherapeutic and drug-induced methods of treatment and prevention of the adhesion process is evaluated, and their insufficient effectiveness is shown. It is noted that the creation of a barrier between the contacting surfaces in the abdominal cavity is the optimal method for preventing spike formation. The methods of creating an anti-adhesion barrier proposed to date are considered. The possibilities of non-invasive diagnostics of adhesive disease using ultrasound are shown, with the main ultrasound signs of abdominal adhesions considered. Preoperative ultrasound allows for assessing the risks of repeated surgical intervention and correctly determining the patient’s routing for delivery.