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

Abstract

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.

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

“…Cesarean scar characteristics have been found to be associated with intra‐abdominal adhesions; however, the number of studies showing this association is still small 9–11 . Striae gravidarum has also been assessed in terms of presence, localization, and severity to evaluate its diagnostic value in predicting the presence of pelvic adhesions at repeat CS, but the results have been inconsistent 12–14 . Recently, a new ultrasonographic sliding sign has been proposed to predict intra‐abdominal adhesions before repeat CS.…”

“…[9][10][11] Striae gravidarum has also been assessed in terms of presence, localization, and severity to evaluate its diagnostic value in predicting the presence of pelvic adhesions at repeat CS, but the results have been inconsistent. [12][13][14] Recently, a new ultrasonographic sliding sign has been proposed to predict intra-abdominal adhesions before repeat CS.…”

Study on the methodology of striae gravidarum severity evaluation

“…Striae gravidarum is a kind of striae distensae commonly observed in primigravid and obese women [ 1 ]. The changes in skin tension and hormone in the abdominal wall during the pregnancy lead to the rupture of elastic fibers of the abdominal skin [ 2 ]. The striae gravidarum presents as irregular purple or light red parallel and slightly concave expansion stripes in abdominal skin, and gradually fading into silver bright stripes [ 3 ].…”

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

“…[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.…”