Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections.
Adult
Case-Control Studies
Cesarean Section, Repeat
/ adverse effects
Cicatrix
/ diagnosis
Female
Humans
Peritoneal Cavity
/ pathology
Postoperative Complications
/ epidemiology
Pregnancy
Risk Assessment
Severity of Illness Index
Striae Distensae
/ diagnosis
Tissue Adhesions
/ epidemiology
Young Adult
Adhesions
Cesarean scar
Prediction
Striae
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
09 Apr 2021
09 Apr 2021
Historique:
received:
13
08
2020
accepted:
30
03
2021
entrez:
10
4
2021
pubmed:
11
4
2021
medline:
22
5
2021
Statut:
epublish
Résumé
The 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. This 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. The 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). Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.
Sections du résumé
BACKGROUND
BACKGROUND
The 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.
METHODS
METHODS
This 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.
RESULTS
RESULTS
The 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).
CONCLUSION
CONCLUSIONS
Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.
Identifiants
pubmed: 33836692
doi: 10.1186/s12884-021-03763-z
pii: 10.1186/s12884-021-03763-z
pmc: PMC8033650
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
286Références
Turk J Obstet Gynecol. 2018 Mar;15(1):28-32
pubmed: 29662713
Pak J Med Sci. 2018 May-Jun;34(3):568-573
pubmed: 30034417
J Invest Dermatol. 2006 Aug;126(8):1688-9
pubmed: 16845405
Br J Dermatol. 1998 Jun;138(6):931-7
pubmed: 9747352
J Gynecol Obstet Hum Reprod. 2019 Dec;48(10):839-843
pubmed: 30928543
J Matern Fetal Neonatal Med. 2014 Sep;27(13):1312-5
pubmed: 24134618
J Matern Fetal Neonatal Med. 2017 Feb;30(4):486-491
pubmed: 27072887
J Burn Care Rehabil. 1990 May-Jun;11(3):256-60
pubmed: 2373734
J Gynecol Obstet Biol Reprod (Paris). 2015 Sep;44(7):621-31
pubmed: 25304098
J Gynecol Obstet Hum Reprod. 2020 Jan;49(1):101619
pubmed: 31430563
Acta Obstet Gynecol Scand. 2011 May;90(5):531-4
pubmed: 21306338
Ginekol Pol. 2019;90(6):325-330
pubmed: 31276184
Hum Reprod. 2002 Jul;17(7):1914-7
pubmed: 12093860
Geburtshilfe Frauenheilkd. 2016 Mar;76(3):268-272
pubmed: 27065488
Int J Gynaecol Obstet. 2013 Apr;121(1):82-5
pubmed: 23340272
Fertil Steril. 2008 Dec;90(6):2324-7
pubmed: 18178195
J Obstet Gynaecol Res. 2014 Jun;40(6):1643-8
pubmed: 24888928
Int J Gynaecol Obstet. 2010 Jan;108(1):65-8
pubmed: 19793585