Abdominal scar characteristics: Do they predict intra‐abdominal adhesions with repeat cesarean deliveries?

Kahyaoğlu, Serkan; Kayıkçıoğlu, Fulya; Kinay, Tugba; Mollamahmutoğlu, Leyla

doi:10.1111/jog.12429

Cited by 25 publications

(24 citation statements)

References 25 publications

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“…In 2 similar studies published by Salim et al [5] and Kahyaoglu et al [6], depressed abdominal scars were reported as being associated with intra-abdominal adhesions. Stocker et al [7], using more detailed scoring methods, suggested that patients with a palpable scar were most likely to have pelvic adhesions.…”

Section: Discussionmentioning

confidence: 59%

“…Repeated CDs have been reported to progressively increase serious maternal complications including higher rates of hemorrhage, uterine rupture, surgical injury, adhesions, and hysterectomy [4][5][6]. Maternal morbidity is markedly raised from 15 to 83% due to the presence of placenta previa and placenta accreta, which increased significantly with repeated CDs compared to vaginal delivery [10].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the absence of a reliable noninvasive method for identifying intra-abdominal adhesions preoperatively, several authors have proposed abdominal scar features as a possible predictor for the presence and severity of adhesions [5][6][7].…”

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confidence: 99%

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Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery

Taylan

Akdemir

Ergenoğlu

et al. 2016

Gynecol Obstet Invest

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Aims: The study aimed to investigate whether we can predict the presence and severity of intra-abdominal adhesions before cesarean delivery using patient history, symptoms, and abdominal skin scar characteristics. Methods: In this prospective study, 143 pregnant women with history of previous abdominal surgery were included and they delivered by cesarean. Preoperative abdominal scar characteristics and symptoms as well as intraoperative abdominal adhesions were evaluated using the Manchester Scar Scale, a symptomatology questionnaire and the More Comprehensive Adhesion Scoring Method, respectively. Results: Patients with adhesions (n = 98) and without adhesions (n = 45) had similar baseline characteristics. In the adhesion group, abdominal scar scoring parameters were significantly increased. However, there was no significant correlation among total scar score, adhesion score, and symptom score. Conclusion: Despite the availability of many proposed methods, accurate prediction of the severity of surgery-related adhesions is beyond our current abilities. Therefore, as healthcare providers, obstetricians should avoid unnecessary use of the cesarean approach. This approach is more effective, beneficial, realizable, and reasonable than the prediction of surgery-related adhesions.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery

Taylan

Akdemir

Ergenoğlu

et al. 2016

Gynecol Obstet Invest

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“…Intraabdominal peritoneal adhesions during surgery were evaluated according to the modified Nair scoring system. [7] According to this system, following definitions were made: grade 0 = no adhesion in the intraabdominal examination; grade 1 = the presence of single band between visceral surface of uterine and abdominal wall; grade 2 = the presence of two bands between visceral surface of uterine and abdominal wall; grade 3 = the presence of more than two bands between visceral surface of uterine and abdominal wall; and grade 4 = the cases where uterine surface is directly adhered to the anterior abdominal wall.…”

Section: Methodsmentioning

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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“…In order to predict adhesion‐related complications preoperatively, cesarean scar and skin characteristics were evaluated previously in patients with repeated CD . The reason behind these efforts was to provide a reliable adhesion marker to identify the risky patients and to improve healthcare service in special populations.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of striae gravidarum extension and localization on predicting intraperitoneal adhesion risk

Kan

Görkem

Alkılıç

et al. 2019

J of Obstet and Gynaecol

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Aim: To evaluate the diagnostic value of striae gravidarum (SG) presence and localization in predicting the intraperitoneal adhesion (IPA) risk in pregnant women with a history of at least one previous cesarean delivery (CD). Methods: A total of 100 pregnant women with repeated CD were included in this prospective observational study. Patients were divided into three groups according to severity of SG with Davey scoring system. Intraoperative adhesion severity and extension were evaluated by using Nair classification system. Moreover, operation duration and neonatal outcomes were analyzed. Results: Demographic features were comparable between the groups. Adhesion scores were significantly higher in mild and severe SG groups (for mild SG: 1.93 AE 0.99, for severe SG: 2.81 AE 0.88 and for no SG: 1.4 AE 0.57; P < 0.001). Analysis revealed a positive correlation between IPA and severity of SG (P < 0.001). There was a correlation between increased striae density and adhesion severity especially in the right and left upper quadrants of the abdomen (for right quadrant: r = 0.515, P < 0.001; for left quadrant: r = 0.359, P = 0.005). Conclusion: Our results suggest that preoperative evaluation of SG severity and extend particularly in upper quadrants is a feasible option to predict IPA risk in patients with repeated CD.

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Abdominal scar characteristics: Do they predict intra‐abdominal adhesions with repeat cesarean deliveries?

Abstract: There is a relation between depressed abdominal scars and intra-abdominal adhesions, whereas pigmentation status does not differ between women with or without adhesions.

Cited by 25 publications

References 25 publications

Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery

Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery

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

Efficacy of striae gravidarum extension and localization on predicting intraperitoneal adhesion risk

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