期刊论文详细信息
BMC Pregnancy and Childbirth
Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections
Ahmed A. Aboelroose1  Ahmed M. Gadallah1  Noha al-Okda1  Zakia M. Ibrahim1  Khaled A. Atwa1  Rasha E. Khamees1  Amal A. Ahmed1  Mohamed Elprince1  Mohamed F. Ibrahim1  Mahmoud A. Greash1  Asmaa M. Elgedawy1  Amira M. Elbahie1  Omima T. Taha1  Osama E. Ashour1  Hanan M. Ghoneim1  Radwa M. Abdel Aal1 
[1] Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt;
关键词: Adhesions;    Cesarean scar;    Prediction;    Striae;   
DOI  :  10.1186/s12884-021-03763-z
来源: Springer
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【 摘 要 】

BackgroundThe current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions.MethodsThis was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey’s scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair’s scoring system was used to evaluate intraperitoneal adhesions.ResultsThe study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value < 0.001). Higher scores for the parameters of the Vancouver scale were present in patients with severe striae (1.69 ± 1.01, 1.73 ± 0.57, 2.67 ± 1.23, and 1.35 ± 1.06 for scar vascularity, pigmentation, pliability, and height respectively with a p-value of < 0.001 each). Thick intraperitoneal adhesions were noted significantly in women with severe striae [21 (43.75%), p-value < 0.001)]. The Davey’s and Vancouver scores showed highly significant predictive performance in the prediction of intraperitoneal adhesions (p-value < 0.001).ConclusionAbdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.

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