Prediction of Intraperitoneal Adhesions in Repeated Cesarean Deliveries with Stria Gravidarum Scoring System: A Cross-sectional Study


YAVUZ O., KURT S., Ozmen S., Bilen E., AKDÖNER A.

NIGERIAN JOURNAL OF CLINICAL PRACTICE, cilt.27, sa.4, ss.489-495, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 27 Sayı: 4
  • Basım Tarihi: 2024
  • Doi Numarası: 10.4103/njcp.njcp_767_23
  • Dergi Adı: NIGERIAN JOURNAL OF CLINICAL PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
  • Sayfa Sayıları: ss.489-495
  • Anahtar Kelimeler: Cesarean delivery, Davey score, intraperitoneal adhesions, striae gravidarum
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Background:The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health. Aim:The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system. Methods:A total of 167 patients with at least one previous CD at or beyond 37 weeks of gestation were analyzed. Preoperative SG was calculated according to the Davey scoring system: 0-2 score were defined as mild SG (Group 1; n: 94, 56.2%), and 3-8 score were defined as severe SG (Group 2; n = 73, 43.8%). Preoperative previous cesarean incision features were evaluated according to the Vancouver scar scale. IPA was evaluated according to the Nair's and modified Nair's scoring systems. Results:Parity, younger age at first pregnancy, higher body mass index, number of previous CDs, rate of scar symptoms, Nair's and the modified Nair's scores were statistically significant in Group 2 (P = 0.01; P = 0.04; P = 0.007; P = 0.004; P < 0.001; P = 0.007; P = 0.02, respectively). Davey score >= 3 and Vancouver score >= 4.5 were determined as the cut-off value to predict IPA (P = 0.1 and 0.07, respectively). According to multivariate analysis, both Davey and Vancouver scores are independent factors in predicting IPA (P = 0.02 and 0.04, respectively). Conclusion:Evaluating the SG score through the Davey score in women with a history of previous CD may assist in predicting IPA status before the planning of a subsequent surgery.