Sliding Sign: Could It Be a New Marker for Predicting Perinatal Outcomes

Abstract

Aim: 
 Adhesions following cesarean section has an important role in the course of subsequent cesarean deliveries and perinatal outcomes. Sliding sign can be proposed as a third trimester transabdominal sonographic marker for the predicting intra-abdominal adhesions in consecutive cesarean sections, skin-to-delivery time and APGAR scores. 
 Methods
 A prospective study was conducted on women with a history of at least one cesarean section. All patients were evaluated at last trimester by real time ultrasonography in terms of sliding sign. The presence and absence of sliding sign, the degree of adhesions, skin-to-delivery time and APGAR scores were recorded.
 Results 
 200 patients were examined. Sensivity and specifity of sliding sign in the prediction of intra-abdominal adhesions were 75.5% and 88.2%, respectively. More severe adhesions were observed in sliding sign negative group whereas the rate of no-adhesion was higher in the sliding sign positive group. Skin-to-delivery time and 1-5 minutes APGAR scores were significantly different between 2 groups. Visceral injury was observed in 6% and bleeding over 1000 ml was seen in 30% of the patients.
 Conclusion 
 Ultrasonographic evaluation of sliding sign may be a reliable method as a predictor tool for presence of intraperitoneal adhesions in repeat cesarean sections.