ArticleRevista da Associacao Medica Brasileira (1992)2023
The effectiveness of preoperative diagnostic methods in predicting intra-abdominal adhesions before repeat cesarean section delivery.
Article in Revista da Associacao Medica Brasileira (1992), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Objective and Non-Invasive Evaluation of Fascial Layers Related to Surgical or Post-Traumatic Scars: A Systematic Review of the Literature.Life (Basel, Switzerland) · 2026Review
- ERAC knowledge, attitudes, and practices among obstetrics and gynecology medical staff.Frontiers in public health · 2026Article
- Lack of Antenatal Care Resulting in Intraoperative Diagnostic Challenges of Dense Adhesions Imitating Placenta Accreta Spectrum: A Case Report.International medical case reports journal · 2026Article
- Comparative outcomes of Palmer, Umbilical Veress needle, and open entry techniques in robotic-assisted surgery: a propensity-matched analysis of 9482 patients.Journal of robotic surgery · 2025Article
- Article
- Does previous gastrectomy history affect the surgical outcomes of laparoscopic cholecystectomy?BMC surgery · 2023Review
- Ultrasonography Sliding Sign as a Predictor for Intraabdominal Adhesions in Repeated Cesarean Deliveries: Retrospective Cross Sectional Study.Journal of clinical ultrasound : JCUArticle
- Article
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3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to evaluate the effectiveness of skin appearance, striae gravidarum severity, and ultrasonographic "sliding sign" in predicting preoperative adhesions before repeat cesarean section delivery on the same patient and find the most useful one.
methodsThis was a prospective cohort study conducted on pregnant women with a history of cesarean section delivery. Davey's scoring system was used for stria evaluation. The scar was assessed using their visual appearance, and transabdominal ultrasonography was applied to detect sliding sign existence. Surgeons blinded to preoperative assessment graded the severity of intra-abdominal adhesions intraoperatively using Nair's scoring system.
resultsOf the 164 pregnant women with at least one previous cesarean section delivery, 73 (44.5%) had filmy or dense intra-abdominal adhesions. Statistically significant association was found between three groups regarding parity, previous cesarean number, scar appearance, total stria score, and sliding sign existence. Negative sliding sign had a likelihood ratio of 4.198 (95%CI 1.178-14.964) for the detection of intra-abdominal adhesions. Stria score and scar appearance were also valuable for detection adhesions with likelihood ratios of 1.518 (95%CI 1.045-2.205) and 2.405 (95%CI 0.851-6.796), respectively. After receiver operator characteristics curve analysis, striae score cutoff value in adhesion prediction was determined as 3.5.
conclusionStria score, scar appearance, and sliding sign are all significant predictors for intraperitoneal adhesions, and sliding sign, as an easy-to-apply, inexpensive, useful sonographic marker, is the most effective adhesion predictor before repeat cesarean section delivery compared to other known adhesion markers.
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