Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: A cross-sectional study

Abbas, Ahmed M.; Saber-Khalaf, Mohammed; Abdel-Reheem, Fatma; Elnashar, I.

doi:10.1016/j.jogoh.2019.08.002

Cited by 13 publications

(18 citation statements)

References 19 publications

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“…Thick intraperitoneal adhesions were noted signi cantly in women with severe striae [21 (43.75%), pvalue <0.001 with mean Davey score of 6.73 ± 0.94). This was following the results reported by Abbas et al; however, they reported that 90% of women with severe striae had thick adhesions with mean Davey score of 4.25 ± 3.36 (10). Another study reported close results to the current one (50% of patients with severe striae had dense adhesions) (12).…”

Section: Discussionsupporting

confidence: 89%

“…This was lower than reported by others (59.6% and 54.3%) (11,13). However, too much higher rates of intraperitoneal adhesions were reported by Abbas et al and Khali et al (87% and 73.5%, respectively) (10,16). This disparity in results would be rendered to differences in surgeons, techniques, and suture materials used in the operations.…”

Section: Discussionmentioning

confidence: 68%

“…The overall prevalence of abdominal striae in the studied population was 49.7% (203/408 women). There were discrepancies in the prevalence of abdominal striae in previous studies with rates of 65.7%, 67.7% among Egyptian women (10,11) and 80%, and 57.9% among Turkish women (12,13). This would be rendered to different sample sizes as well as different races among the studied populations.…”

Section: Discussionmentioning

confidence: 78%

“…The subanalysis performed for the study group demonstrated signi cant differences in the demographic characters (p va2lue 0.001 for almost all variables). In the cohort evaluated in a recent study, there were no differences in the demographic data of the recruited population (10). However, in the cohort evaluated by another researcher, a signi cant difference was reported between the three groups in age, BMI, weight gain during pregnancy, and fetal weight (11).…”

Section: Discussionmentioning

confidence: 99%

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Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections

Elprince

Taha

Khamees

et al. 2020

Preprint

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Background: The current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions.Methods: This was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey's scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair's scoring system was used to evaluate intraperitoneal adhesions.Results: The study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value <0.001). Higher scores for the parameters of the Vancouver scale were present in patients with severe striae (1.69 ± 1.01, 1.73 ± 0.57, 2.67 ± 1.23, and 1.35 ± 1.06 for scar vascularity, pigmentation, pliability, and height respectively with a p-value of <0.001 each). Thick intraperitoneal adhesions were noted significantly in women with severe striae [21 (43.75%), p-value <0.001)]. The Davey's and Vancouver scores showed highly significant predictive performance in the prediction of intraperitoneal adhesions (p-value < 0.001).Conclusion: Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections

Elprince

Taha

Khamees

et al. 2020

Preprint

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“…[11,12] Unlike other results, there are studies reporting that the severity of pelvic adhesions increase as SG score increases. [13][14][15] On the other hand, there are also studies reporting that the severity of pelvic adhesions decrease as SG score increases. [16] All these different results can be explained with the factors such as the less number of patients, different ethnic groups, different exclusion criteria, different methodologies, and different numbers of previous cesarean section.…”

Section: Discussionmentioning

confidence: 99%

The assessment of the prediction capacity of abdominal striae gravidarum on intraabdominal adhesions in the pregnant women with the history of cesarean section evaluated before the cesarean section

Madendağ¹,

Şahin²

2019

Perinatal J

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Sezaryen hikâyesi bulunan gebelerde sezaryen öncesi de¤erlendirilen abdominal striae gravidarum seviyesinin intraabdominal yap›fl›kl›klar› öngörebilirli¤inin de¤erlendirilmesi Amaç: Operasyon öncesi intraabdominal yap›fl›kl›k olup olmad›¤›-n› veya yap›fl›kl›¤›n fliddetini öngörebilmek amac›yla klinik ve ultrasonografik araflt›rmalar yap›lmaya devam etmektedir. Operasyon öncesi yap›fl›kl›¤›n fliddetinin tespiti ile intraoperatif cerrahi komplikasyonlar› önlemek mümkün olacakt›r. Striae gravidarum gelifliminin ba¤ dokusu ve kollajen geliflimi ile iliflkili oldu¤u düflü-nüldü¤ünde mevcut çal›flmada sezaryen hikayesi bulunan gebelerde sezaryen öncesi abdominal striae gravidarum varl›¤›n› ve fliddetini de¤erlendirerek striae gravidarumun intraabdominal yap›fl›k-l›klar› öngörebilirli¤ini de¤erlendirmeyi amaçlad›k. Yöntem: Tersiyer bir merkezde prospektif kesitsel bir çal›flma olarak 6 ay süre içinde baflvuran gebeler çal›flmaya dahil edildi. Maternal yafl, vücut kitle indeksi, gebelikte al›nan toplam kilo mikta-r›, pregestasyonel veya gestasyonel diyabet varl›¤›, sigara kullan›-m›, kronik sistemik hastal›k varl›¤›, geçirilmifl sezaryen say›s› ve bebek do¤um a¤›rl›klar› ile mevcut gebelikteki do¤um haftas›, fetal a¤›rl›k ve fetal cinsiyet kaydedildi. Striae gravidarum fliddeti Davey skorlama sistemi ile belirlendi. ‹ntraabdominal peritoneal adezyonlar modifiye Nair skorlama sistemine göre de¤erlendirildi. Striae gravidarum fliddetine göre 3 grup oluflturuldu. Bulgular: D›fllama kriterleri sonras› kalan 378 hasta 3 grup olarak karfl›laflt›r›ld›. Gruplar aras›nda demografik özellikler aç›s›ndan fark yoktu. Striae gravidarum fliddeti ile peritoneal adezyon fliddeti aras›nda istatistiksel olarak bir iliflki bulunamad› (p=0.401). Ay-r›ca skar görünüm tipleri (p=0.215) ve keloid varl›¤› (p=0.127) ile striae gravidarum aras›nda da anlaml› bir iliflki yoktu. Sonuç: Striae gravidarum skorunun keloid ve skar görünümü ile iliflkisiz oldu¤u, peritoneal adezyonlar› önceden tahmin etmede baflar›s›z bir belirteç olaca¤›, kullan›lsa dahi çok düflük özgüllük de¤erlerine sahip olaca¤› görüflündeyiz.

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Preoperative sonographic sliding sign for prediction of intra‐abdominal adhesions before repeat cesarean delivery

Charernjiratragul

Suntharasaj

Pranpanus

et al. 2022

Intl J Gynecology & Obste

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Objective To evaluate the usefulness of the uterine sliding sign for predicting intra‐abdominal adhesions in women undergoing repeat cesarean section (CS) and the association of the sliding sign with other operative and neonatal outcomes. Methods A prospective cohort study was conducted among pregnant women with at least one previous CS. Transabdominal ultrasonography was performed and classified as a positive or negative sliding sign. Surgeons blinded to the sonographic results assessed intra‐abdominal adhesions. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Operative and neonatal outcomes of the positive and negative sliding sign groups were compared. Factors associated with intraoperative adhesions were also analyzed. Results A total of 380 women were recruited. The sensitivity and specificity of the uterine sliding sign to detect moderate‐to‐thick adhesions were 60.6% and 91.9%, respectively. A negative sliding sign was significantly associated with a higher incidence of adhesions, longer skin‐to‐delivery time, longer total operative time, and lower 5‐min APGAR score in newborns. A negative sliding sign and history of two or more previous CS were significant predictors of moderate‐to‐thick adhesions. Conclusion The uterine sliding sign is an independent predictor of intraoperative adhesions, with acceptable sensitivity and high specificity and negative predictive value.

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Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: A cross-sectional study

Cited by 13 publications

References 19 publications

Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections

Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections

The assessment of the prediction capacity of abdominal striae gravidarum on intraabdominal adhesions in the pregnant women with the history of cesarean section evaluated before the cesarean section

Preoperative sonographic sliding sign for prediction of intra‐abdominal adhesions before repeat cesarean delivery

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