Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objective: To investigate the value of preoperative ultra-sonographic sliding sign in prediction of intra-abdominal adhesions and their related complications in pregnant women in third-trimester with history of previous abdomino-pelvic surgery. Methods: A Prospective observational study in which158full-termpregnant women with history of previous abdomino-pelvic surgery admitted for elective caesarian section were selected then underwent Trans-abdominal ultra-sonography and the sonographer recorded a video clip to determine whether the structure glided freely in relation to adjacent structures. To be considered as sliding, the structures have to glide easily, one against the other (positive sliding sign); no motion of the structure in question signaled a negative sliding sign. During surgery, a detailed description of intra-abdominal adhesions done by surgeons blinded to the ultra-sonographic findings and thenthe operative findings were correlated to the corresponding ultra-sonographic sliding sign. Results: A negative sliding sign was associated with severe intra-abdominal adhesions, increased risk of complications such as bladder, bowel injury, hemorrhage and significant longer delivery time compared to positive one with (71.4%sensitivity, 95.8% specificity, 62.5% PPV and 97.1%NPV)

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