Association of Intra-Abdominal Adhesions with Ultrasonographic Sliding Sign in Third Trimester Women Prior to A Repeated Cesarean Section

Introduction: Adhesions are the most frequent complication following abdominal and pelvic surgery, developing after more than 90% of interventions concerning the abdominal cavity.Objective: To evaluate the efficiency of preoperative transabdominal ultrasonographic features in prediction of intra-abdominal adhesions in pregnant women during third-trimester with history of previous cesarean surgery scheduled for a planned repeat elective C.S. delivery.Patients and Methods: This prospective observational study was conducted at tertiary care hospital at Ain shams University Maternity Hospital from January 2023 till October 2023 and performed on total 200 patients who underwent elective cesarean delivery.Results: The findings of our study demonstrated a good capability of a simple third-trimester transabdominal sonographic sign, the absence of sliding of the uterus, to predict the presence of intra-abdominal adhesions in women undergoing repeat CS.Conclusion: It may also guide the surgeon’s choice while entering the abdominal cavity, to decrease the risk of bowel or vessel injury or conversion. The TAS sliding sign can also help in assessment of the severity of adhesions, allowing the patient to be referred to a multidisciplinary center with expertise in bladder and bowel surgery, and guiding the planning of the operation.