Sonographic Sliding Sign as a Predictor of Intra- Abdominal Adhesions in Pregnant Woman with Previous Pelvi-Abdominal Surgery | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 87, Volume 92, Issue 1, July 2023, Page 6033-6038 PDF (595.35 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2023.311044 | ||||
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| Abstract | ||||
| Background: Intra-abdominal adhesions are frequently linked to higher likelihood of complications such as hemorrhage and visceral injury during cesarean section in a woman with previous pelvi-abdominal surgery. This is why prediction of intraoperative adhesions is important. Objective: To check the sonographic sliding sign of the uterus as a predictor of intra-abdominal adhesions prediction in females who are undergoing CS and who had a history of pelvic and abdominal surgery, involving a previous CS. Methods: A prospective observational study carried out on 69 females with history of previous pelvi-abdominal surgery including CS and planned to have CS to predict intra-abdominal adhesions. During deep breathing, transabdominal ultrasound (TAS) is utilized to demonstrate the sonographic sliding sign of the uterus beneath the inner fascia of abdominal muscles. Females were believed to be at a high hazard for severe adhesions when sliding was absent but at a low hazard when sliding was obvious. Intraoperative assessment of adhesions was done in correlation to the sonographic finding. Results: 5 out of 8 cases with -ve sliding sign were confirmed intraoperatively to have marked adhesions and 59 out of 61 cases with +ve sliding sign had no or mild adhesions. The sensitivity, specificity, ppv, npv of the sliding sign were 71.4%, 95.2%, 62.5%, and 96.7% respectively. Conclusion: The uterine sliding sign has a good specificity, negative predictive value, and moderate sensitivity for predicting intraoperative adhesions. This technique might help surgeons to undertake anticipated complex operations. | ||||
| Keywords | ||||
| Sliding sign; Intra-abdominal adhesions; Abdominal ultrasound | ||||
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