approximation of both recti during lower segment cesarean section may be an important step to lower incidence of intraabdominal adhesions . peritoneal adhesions are of major medical importance and are associated with clinical problems such as chronic pain and infertility.

all patients included in the study should be had the operative history of the previous cesarean section and were done in the cairo university and divid them into 2 groups. 1st group were both recti approximated while the second group were closed without approximating both recti. all patients will be subjected to lower segment cesarean segment to assess the intraperitoneal adhesions, mean operative time, mean hospital stay, postoperative distension, bowel sounds, postoperative infections and morbidity

Inclusion Criteria:

• all patients of first lower segment cs at kasr al ainy with previous recorded data including operative data, postoperative data including complications. all patients included in the study are elective cesarean section at 38 weeks of gestation

Exclusion Criteria:

• no history of infection or medical disease
• no history of previous laparotomies
• no history of pregnancy complications
• patients noted to have intraperitoneal adhesions in first cesarean section

patients who will subjected to cesarean section with history of previous cesarean section in the same hospital with operative notes and techniques