Does cesarean delivery increase the prevalence of adenomyosis? a retrospective review

Objective: To assess the correlation between cesarean delivery and adenomyosis. Methods: A retrospective chart review of 200 patients who underwent a hysterectomy for benign pathology at our institution was performed. A systematic review of the surgical histopathology reports for these patients was conducted. The charts of these patients were subsequently reviewed for any previous history of cesarean delivery. The authors then computed the data of this case-control study and calculated an odds ratio. Results: The results of our study were as follows. Of the 200 patients who were included in the study, 64 (32%) were found to have adenomyosis either alone (30/200 or 15%), or in association with leiomyomas (34/200 or 17%). Of these 64 patients with adenomyosis, 19 (24.6%) had a history of cesarean delivery, with a total number of 36 cesarean deliveries performed. Forty-five patients (22.5%) who had not undergone cesarean delivery had the histopathologic diagnosis of adenomyosis. Forty-four patients (22%) had a history of cesarean delivery. The odds ratio for this case-control study was computed at 1.9. Conclusions: The prevalence of adenomyosis reported in the literature is 15–20%. The odds ratio of 1.9 suggests an increased prevalence of adenomyosis in patients with previous cesarean delivery. However, to add power and statistical significance, more data are currently being collected.