European Journal of Cardiovascular Medicine

Introduction: Dense adhesions may cause prolonged surgery, injury to bowel, or bladder, and also excessive bleeding , during adhesiolysis and entry to abdominal cavity, especially when these procedures are performed by inexperienced surgeons as assistant doctors at training hospital Aims: Aim to study preoperative detection of adhesions by sonographic sliding sign  and determines its accuracy rate which will highlight its effectiveness in prevention of the complications during C- section. Materials and methods: This was a prospective observational study conducted at the Department of Obstetrics and Gynaecology, Izmir Katip Celebi University, Ataturk Training and Research Hospital in 70 full term pregnant women with history of C- section, included in this study. All patients were admitted to our clinic for elective C-section and sonographic evaluation done preoperatively to assess the “sliding sign “for detection of adhesions between uterus and abdominal wall. Results: Our analysis shows that significant positive sliding sign in intraoperative adhesions, so the accuracy rate is 77.4%, which can be assumed as optimal. Other characteristics found to have no correlation with the adhesions and hgb drop level. Haemoglobin drop degree is also correlate with the sliding sign. The predictivity of hgb drop more than >2 g/dl has the highest correlation with the sliding sign. Accordingly, the sensitivity, specificity, PPV and NPV of sliding sign in predicting marked intra-operative adhesions were 87.5%, 62.5%, 77.7% and 76.9% respectively. The median of delivery time (time from skin incision till delivery of baby) was significantly longer in patients with negative sliding sign compared to those with positive sliding sign (18 minutes versus 8 minutes) Conclusion: The sliding sign by ultrasound has a sensitivity of 87.5%, specificity of 62.5%, a positive predictive value of 77.7%, a negative predictive value of 76.9%, and accuracy of 77.5%, considering it rapid, easy and reliable method for prediction of intraperitoneal adhesions.