Objective:

To compare the effectiveness of fluid barriers, Clexane® “enoxaparin sodium” and methylene blue, in prevention of adhesion formation after cesarean section. We aimed to reduce the secondary infertility caused by adhesions after the operation

Design:

Pregnancy was terminated on the day 21 of gestation by cesarean section via bilateral uterine incision in 24 inbred, pregnant Wistar-Albino rats. The rats were divided into three groups.

Interventions:

The first group underwent standard surgery, where intra-peritoneal saline was given before abdominal closure. In the second group, methylene blue was sprayed on the defect at the anterior uterine horn after cesarean operation, whereas Clexane ® "Low-Molecular-Weight Heparin" (LMWH) was sprayed in the third group. After 3 weeks, all rats were sacrificed in order to determine the adhesion scores. Macroscopic and microscopic adhesion scores were statistically analyzed among groups.

Main outcome measures:

No significant difference was detected between methylene blue group and control group in terms of adhesion scores (p>0.05). It was found that adhesion scores in the LMWH group was significantly higher than the control group, suggesting that adhesions was increased by the administration of LMWH (p<0.05).

Conclusion:

According to results of our study, direct application of liquid adhesion barriers to injured surface seems to be partially ineffective in the prevention of adhesions after cesarean section; rather, it was found that these liquid barriers which impairs control of bleeding might cause an increase in adhesion formation.

Keywords: rat, cesarean section, adhesion, low molecular weight heparin, methylene blue, secondary fertility.