Document Type
Original Article
Abstract
Background: One of the most frequent obstetric procedures is the caesarean section (CS). Abdominal adhesion formation is thought to be at risk due to CS.
Aim: to evaluate intrapelvic adhesion with prior CS or any other pelvic surgery was predicted using clinical data and an ultrasound sliding sign.
Patients& methods: In this cross sectional study, conducted between 2019 and 2022 enrolled 500 pregnant-women with previous-pelvic surgery and planned to CS. Thorough history and clinical evaluation were done. Preoperative evaluation of striae gravidarum severity using Davey score. Ultrasound assessment for sliding sign was done. Intraoperatively, severity of intrapelvic adhesion was done by Nair’s scoring system.
Results: Sliding sign was positive in 355 (71%). Intra pelvic adhesions were found in 245 (49%) women and 90 (18%) women had dense adhesion. Predictors for intra pelvic adhesions were depressed scar, ≥ three previous CS, abdominal stria and negative sliding sign. The best predictor was negative sliding sign with 71.9% overall accuracy. Also, the only predictor of dense intra pelvic adhesion was ≥ three previous CS with overall accuracy was 72.1% for prediction of dense intra pelvic adhesion.
Conclusion: we present a rapid and easy-to-perform method to identify intra-abdominal adhesions in women undergoing cesarean delivery. The best accuracy was achieved with sliding status, depressed scar and > 3 three CSs. Multi centers future studies are required to confirm these findings
Keywords
cesarean section, intrapelvic adhesion, Nair’s score, sliding sign
Subject Area
Obstetrics and Gynecology
How to Cite This Article
Hussein, Samar Hassan; Ali, Faisal moustafa; and Fouad, Mahmoud Mohamed Ahmed
(2023)
"Ante natal prediction of intra pelvic adhesion prior to caesarean section,"
Al-Azhar International Medical Journal: Vol. 4:
Iss.
9, Article 29.
DOI: https://doi.org/10.58675/2682-339X.2043
