The Value of Ultrasonographic Sliding Sign in Prediction of Intra-Abdominal Adhesions in Pregnant Women Undergoing Cesarean Section Following Abdominopelvic Surgery: A Prospective Study | ||||
| The Egyptian Journal of Fertility and Sterility | ||||
| Volume 29, Issue 1 - Serial Number 11106352, January 2025, Page 67-74 PDF (250.22 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2025.409770 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
FF Darweesh; gamal oma abdelghany Hussein; ghada abdelfatah abdelmoety; Mohamed El Sharkawy  ; Dina Latif
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| Department of obstetrics and gynecology , Cairo university, Cairo, Egypt | ||||
| Abstract | ||||
| Objective: The current evidence is inconclusive regarding the utility of sliding sign for prediction of intra-abdominal adhesion. In the present study, we assessed the diagnostic accuracy of negative sliding sign for prediction of intra-abdominal adhesion in pregnant women scheduled for Cesarean section (CS) and had a history of previous abdominopelvic surgery. Methods: A prospective, observational, study was conducted on 158 full-term pregnant women who were candidates for elective cesarean section. Results: A total of 16 (10.2%) women had negative sliding sign and 8.9% had marked adhesions. The positive sliding sign accurately detected 138 (95.8%) out of 144 patients with no or minor adhesions, while the negative sliding sign correctly recognized 10 (71.4%) out of 14 patients with significant adhesions during the CS treatment. The sliding sign demonstrated a sensitivity of 71.4%, specificity of 95.8%, positive predictive value (PPV) of 62.5%, and negative predictive value (NPV) of 97.1% in predicting significant intra-operative adhesions. In contrast, patients who did not exhibit a sliding sign had a higher probability of suffering from intra-operative bleeding, a significant decrease in hemoglobin levels of more than 3 g/dl, visceral injury, and a longer delivery time (p <0.001). Conclusion: In conclusion, our findings highlight that the negative sliding sign can be used for prediction of severe intra-abdominal adhesions; the negative sliding sign is an accurate, reproducible, and easily accessible method for prediction of adhesions in clinical setting. Moreover,patients with negative sliding sign appears to have higher risk of prolonged delivery, intra-operative bleeding, and visceral injury. | ||||
| Keywords | ||||
| Keywords: Intra-abdominal adhesion; Cesarean section; Maternal outcomes; Sliding sing; Ultrasound | ||||
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