Cesarean section as a risk factor for the development of adenomyosis uteri.

OBJECTIVE To estimate whether there is an association between cesarean delivery and the subsequent development ofadenomyosis uteri based on pathologic diagnosis. STUDY DESIGN A total of 601 patients who had had a hysterectomy at a community hospital were identified. Data were collected from their medical records, focusing on uterine pathology and prior obstetric history. These data formed the basis for a case-control study to disclose an association between cesarean delivery and the subsequent development of adenomyosis uteri. RESULTS Among 189 women with adenomyosis, cesarean delivery had occurred in 25%. This contrasted with 14% cesarean deliveries among those 178 women without adenomyosis, for an odds ratio of 2.08. These 2 groups were comparable in make-up in regard to demographic variables and medical history. CONCLUSION There is strong association between adenomyosis and previous cesarean section. This association raises important questions about whether technical aspects of cesarean section may contribute to the consequence of adenomyosis.