**8. Previous CS/surgery with extensive adhesions**

Adhesions are common following cesarean delivery and after abdominal surgery. The extent of adhesions varies among individuals. In the presence of adhesions, the

cesarean section and fetal extraction are difficult, incision to delivery time is prolonged and the risk of complications such as hemorrhage, bowel or bladder injury is heightened [2, 14, 15].

	- Clamp the adhesion, cut and tie it with vicryl
	- Try to open the peritoneal cavity by cutting higher up
	- Try to separate the bowel from the adherent tissue using sharp dissection
	- Those are also tied and cut through, in order to secure easy access to the lower uterine segment
	- Do not hesitate to call in the help of other specialities and your seniors!
