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Home > Archives > Volume 20, No 8 (2022) > Article

DOI: 10.14704/nq.2022.20.8.NQ44917

Assessment of the relation of striae gravidarum and scar characteristicswith peritoneal adhesions in patients with previous cesarean section

Hind Hameed Hasan, Thana'a Ibrahim Mahmoud, Basim Ghaeb Mukhtar

Abstract

Background Cesarean section is the most common major obetetric surgery and oldest operation in the field the of abdominal surgery. Aim of the study : to evaluate the role of striae gravidarum and scar characteristics in the prediction of peritoneal adhesions in patients with previous one cesarean section. Patient and method :In this cross-sectional study, we evaluated 113 pregnant women at > 36 weeks of gestation ,had previous one cesarean delivery(regardless the indication of the previous c/s) who admitted to the gynecology and obstetric unit of Salah al-deen general hospital and undergoed their second (emergency or elective) cs ,study done over a period from 15th December 2021 to 15th May 2022 . All participants gave informed consent before being included in the study.. An interview was carried out with these patients using questionnaire form .The study authorized by department of gynecology and obstetric in Tikrit university/college of medicine. Half of sample evaluated for SG (have flat non pigmented scar) and other half evaluated for scar characterestics (davey's score=0). Results :Average age(18-42) year, GA(36 - 40+2) weeks,64% of cases are ˃38 wks, BMI range (24- 34.4),only 4 patients were smokers .Also 64% of participants are P1. 56.6% of cases had peritoneal adhesion(PA) in varying degrees. Increasing GA,BMI shows significance relation with mild and severe SG(p-value =0.044,0.004)respectively , depressed scars and pigmented one appear to be more prominent when BMI(25-30)(p-value=0.007) and time since previous c/s was ≥2 years(p-value=0.047). Scar pigmentation found to be more in P1 women(p-v=0.035). keloid scar correlate significantly with gap between c/s ˂ 2 years(p-value=0.015). Higher degrees of peritoneal adhesions were found in cases with severe SG(p-value=0.0006), although mild adhesions correlate with mild SG. Severe adhesions found obviously in depressed scars and pigmented scars found in 58.8% of the cases which had PA(pvalue=0.0006). Scar length ˃13 cm associated with presence of PA in 75.7% of study sample,(pvalue=0.032). Conclusions : Abdominal striae gravidarum are significant predictor for intra peritoneal adhesions. Women with severe striae gravidarum had severe intraperitoneal adhesions. Cesarean skin scar pigmentation and presence of non-flat scars "depressed specifically" could be associated with the presence of intra-abdominal peritoneal adhesions during repeatCD. Increasing scar length can predict peritoneal adhesions

Keywords

striae gravidarum; scar characteristics; peritoneal adhesions; cesarean section

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