A reliable way to predict intraabdominal adhesions at repeat cesarean delivery: scar characteristics

Doğan, Nasuh Utku; Haktankacmaz, Seval A.; Doğan, Selen; Özkan, Özlenen; Çelik, Hatice; Eryılmaz, Özlem Gün; Doğanay, Melike; Gülerman, Cavidan

doi:10.1111/j.1600-0412.2011.01080.x

Cited by 22 publications

(25 citation statements)

References 21 publications

(21 reference statements)

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“…Dans notre étude, le risque de trouver des adhérences sévères était multiplié par 7,6 en cas de cicatrice déprimée. En revanche, d'autres auteurs ont montré que c'est plutôt l'aspect chéloïde de la cicatrice qui permet de prédire l'existence d'adhérences notamment sévères [21,22].…”

Section: Discussionunclassified

“…Si bien que Dogan et al [21] ont démontré que la longueur et la largeur de la cicatrice sont directement corrélées à la formation des adhérences. Par contre, Salim et al [13] ont postulé que ces deux paramètres n'avaient pas de corrélation avec la présence d'adhérences ; ce qui se trouve en accord avec nos résultats.…”

Section: Discussionunclassified

“…Nous nous trouvons en accord avec Salim et al [13]. En revanche, Dogan et al [21] ont retrouvé des résultats contradictoires. Ils ont montré que les adhérences étaient plus fréquentes et plus fréquemment denses en cas de cicatrice pigmentée (53,2 % vs 31,5 %, p < 0,01 et 26,6 % vs 9,3 %, p < 0,05, respectivement).…”

Section: Discussionunclassified

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Les caractéristiques de la cicatrice pariétale de césarienne sont des facteurs prédictifs des adhérences pelviennes. Étude de cohorte prospective

Khlifi¹,

Meddeb²,

Kouira³

et al. 2015

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Les caractéristiques de la cicatrice pariétale de césarienne sont des facteurs prédictifs des adhérences pelviennes. Étude de cohorte prospective

Khlifi¹,

Meddeb²,

Kouira³

et al. 2015

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…The application and results of using this classification system remain to be seen. The characteristics of the previous incision scar might provide an idea about the severity of intra-abdominal adhesions [11,28]. In a study, the authors reported that elevated scars are associated with increased dense adhesions [28].…”

Section: Commentmentioning

confidence: 99%

“…The characteristics of the previous incision scar might provide an idea about the severity of intra-abdominal adhesions [11,28]. In a study, the authors reported that elevated scars are associated with increased dense adhesions [28]. In another study, women with keloids on the cesarean scar have increased adhesions between the uterus and the bladder, and between the uterus and the abdominal wall [11].…”

Section: Commentmentioning

confidence: 99%

Classification of intra-abdominal adhesions after cesarean delivery

Tulandi

Lyell

2012

Gynecol Surg

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The objective of the study was to develop a standard classification for adhesions after cesarean delivery. We searched the Medline, Pubmed, EMBASE, and the Cochrane database of systematic reviews from 1996 through 2011 for all articles pertaining to adhesion scoring after a cesarean delivery. We performed the search using the keywords "cesarean, adhesions, repeat cesarean, intra-abdominal adhesions, adhesion scoring system, and adhesion classification." Most published adhesion scoring systems were non-site-specific or unclearly described. The most comprehensive adhesion scoring systems were described in three prospective studies that came from two institutions. The scoring systems were similar, site-specific, involving over four sites, and assessing the severity and consistency of adhesions. We combined the two scoring systems to develop a standardized classification of adhesions after cesarean delivery. To date, there are no uniform classifications of intra-abdominal adhesions after cesarean delivery. We hereby outline the first standardized classification of adhesions after cesarean delivery.

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Does the appearance of the cutaneous scar after cesarean section reflect the residual myometrial thickness?

Naimi

Mouzakiti

Eißmann

et al. 2021

Arch Gynecol Obstet

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Purpose The aim of this study is to utilize the Manchester scar scale (MSS) and ultrasound in investigating the association between uterine wall defects and cutaneous scar characteristics after cesarean section (CS). Methods This is a prospective cohort study. The degree of myometrial loss was quantified by calculating a residual myometrial thickness (RMT) ratio as a percentage of RMT to the pre-cesarean anterior uterine wall thickness. Cutaneous scar assessment was performed according to the MSS. Spearman’s correlation and the Kruskal–Wallis test with a cut-off value of p < 0.05 were used for statistical analysis. Results Two hundred forty seven women, of which 2.4% had an Asian, 3.6% an Afro-American, 82% a Caucasian and 12% a Mediterranean background, were recruited. The RMT ratio ranged between 11.9 and 100% with a median of 55.8% and an average of 56%. MSS scores ranged from 4 to 13 with a median of 5 and an average of 6. Spearman’s correlation between MSS and RMT ratio show a rho of − 0.01 with a p value of 0.8. The correlation between MSS and RMT ratio within the four ethnical groups showed a p value between 0.3 and 0.8 and a rho between 0.8 and − 0.8. The Kruskal–Wallis test showed an eta2 of 0.13 and a p value of 0.0002 for the effect of ethnicity on MSS and an eta2 of 0.009 and a p value of 0.68 for the effect of ethnicity on the RMT ratio. Conclusion CS laparotomy scars heal differently between ethnical groups, but generally with satisfying results. Ethnicity does not affect myometrial healing and scar appearance does not reflect myometrial healing after CS. Thus, separate uterine sonographic assessment is recommended.

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A reliable way to predict intraabdominal adhesions at repeat cesarean delivery: scar characteristics

Abstract: There is an association between scar type and adhesions, particularly for hypertrophic scars and dense adhesions.

Cited by 22 publications

References 21 publications

Les caractéristiques de la cicatrice pariétale de césarienne sont des facteurs prédictifs des adhérences pelviennes. Étude de cohorte prospective

Les caractéristiques de la cicatrice pariétale de césarienne sont des facteurs prédictifs des adhérences pelviennes. Étude de cohorte prospective

Classification of intra-abdominal adhesions after cesarean delivery

Does the appearance of the cutaneous scar after cesarean section reflect the residual myometrial thickness?

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