Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Department of Gynecology and Obstetrics, T.C. Sağlık Bakanlığı Karacabey Devlet Hastanesi, Bursa, Turkey.
Niger J Clin Pract. 2024 Apr 1;27(4):489-495. doi: 10.4103/njcp.njcp_767_23. Epub 2024 Apr 29.
The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health.
The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system.
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.
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).
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.
随着重复剖宫产（CD）的增多，预测其术前腹腔内粘连（IPA）对于母婴健康至关重要。
本研究旨在通过妊娠纹（SG）评分系统预测重复 CD 中的 IPA。
共分析了 167 例至少有一次在 37 周及以上行剖宫产史的患者。根据 Davey 评分系统计算术前 SG：0-2 分为轻度 SG（1 组；n=94，56.2%），3-8 分为重度 SG（2 组；n=73，43.8%）。根据温哥华瘢痕量表评估术前剖宫产切口特征。根据 Nair 和改良 Nair 评分系统评估 IPA。
2 组间的产次、首次妊娠年龄较小、较高的体重指数、剖宫产次数、瘢痕症状发生率、Nair 和改良 Nair 评分均有统计学差异（P=0.01；P=0.04；P=0.007；P=0.004；P<0.001；P=0.007；P=0.02）。Davey 评分≥3 和温哥华评分≥4.5 被确定为预测 IPA 的截断值（P=0.1 和 0.07）。多因素分析显示，Davey 和温哥华评分均为预测 IPA 的独立因素（P=0.02 和 0.04）。
在有既往剖宫产史的女性中，通过 Davey 评分评估 SG 评分可能有助于预测后续手术前的 IPA 状态。
