Preoperative Sonographic Prediction Of Intra-Abdominal Adhesions In Repeat Caesarean Section Pregnancy: A Prospective Observational Study
Keywords:
Sliding Sign, Intra-abdominal Adhesions, Repeat Caesarean Section, Preoperative Sonographic Prediction, Tertiary Care ObstetricsAbstract
Objectives: The "sliding sign" technique involves observing the movement between the uterus and the abdominal wall during respiration. A positive sliding sign indicates free movement, suggesting the absence of significant adhesions, while a negative sliding sign suggests restricted movement due to adhesions. This prospective observational study aims to evaluate the accuracy of preoperative transabdominal ultrasonography using the sliding sign in predicting intra-abdominal adhesions among women undergoing repeat caesarean section at a tertiary care centre.
Methods: This prospective observational study was conducted at a tertiary care centre conducted during February 2024 – September 2024 to evaluate the efficacy of preoperative transabdominal ultrasonography in predicting intra-abdominal adhesions among women scheduled for repeat caesarean sections (CS). Demographic data, including age, body mass index (BMI), parity, smoking status, and previous CS details, were recorded. The ultrasonographic findings were compared with intraoperative assessments to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the sliding sign in predicting intra-abdominal adhesions.
Results: The study demonstrates a significant relationship between preoperative sliding sign and multiple clinical factors, including age, BMI, previous caesarean sections, and intraoperative adhesions. The presence of dense adhesions was strongly correlated with a negative sliding sign, reinforcing its role as a potential predictor of intra-abdominal adhesions in repeat caesarean section pregnancies.
Conclusion: The transabdominal sliding sign is a valuable, non-invasive tool for predicting intra-abdominal adhesions in women undergoing repeat caesarean sections. Its application in preoperative evaluations can facilitate better surgical planning and potentially reduce the incidence of intraoperative complications.
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