Zekai Tahir Burak Maternity Hospital, Ankara, Turkey.
Acta Obstet Gynecol Scand. 2011 May;90(5):531-4. doi: 10.1111/j.1600-0412.2011.01080.x. Epub 2011 Mar 16.
To evaluate association between scar characteristics and intraabdominal adhesions at repeat cesarean delivery.
A prospective, cross-sectional study.
Tertiary Government Maternity Training Hospital in Ankara, Turkey.
295 pregnant women with at least one prior cesarean delivery.
All women were at least 36 weeks pregnant. Appearance of previous cesarean delivery scars was categorized into three groups - flat, depressed and elevated. Pigmentation status was also noted (non-pigmented or pigmented).
Intraoperatively detected adhesions, evaluated and classified into three groups (no adhesion, filmy adhesion and dense adhesion groups) by a modified Nair's classification.
Elevated scars had significantly more dense adhesion formation than depressed ones (31.4 vs. 12.7%, p=0.02). No difference was found for dense adhesions when depressed and flat scars were compared (12.7 vs. 6.8%, p=0.124). Of flat scars, 93.2% were free of dense adhesions. Pigmented scars had more dense adhesions than non-pigmented (26.6 vs. 9.3%, p<0.01). Using logistic regression analysis scar length, scar width and appearance of scar (flat or non-flat) were directly related to adhesion formation.
There is an association between scar type and adhesions, particularly for hypertrophic scars and dense adhesions.
评估剖宫产术后再次粘连与瘢痕特征的相关性。
前瞻性、横断面研究。
土耳其安卡拉的三级政府妇产医院。
295 名至少有一次剖宫产史的孕妇。
所有孕妇均妊娠至少 36 周。将先前剖宫产瘢痕的外观分为三组：平坦、凹陷和隆起。还记录了色素沉着状态（非色素沉着或色素沉着）。
术中发现的粘连，并通过改良的 Nair 分类法评估和分为三组（无粘连、薄膜状粘连和致密粘连组）。
隆起的瘢痕形成致密粘连的比例明显高于凹陷的瘢痕（31.4%比 12.7%，p=0.02）。与凹陷的瘢痕相比，平坦的瘢痕形成致密粘连的比例无差异（12.7%比 6.8%，p=0.124）。93.2%的平坦瘢痕无致密粘连。色素沉着的瘢痕形成致密粘连的比例高于非色素沉着的瘢痕（26.6%比 9.3%，p<0.01）。使用逻辑回归分析，瘢痕长度、宽度和外观（平坦或不平坦）与粘连形成直接相关。
瘢痕类型与粘连之间存在相关性，尤其是对于增生性瘢痕和致密粘连。
