Predictive value of striae gravidarum severity for intraperitoneal adhesions or uterine scar healing in patients with previous caesarean delivery

J Matern Fetal Neonatal Med. 2014 Sep;27(13):1312-5. doi: 10.3109/14767058.2013.856876. Epub 2013 Nov 13.

Abstract

Objective: Previous abdominal operations might cause severe intraperitoneal adhesions (IPA), which can complicate caesarean section (CS) procedures. When selecting the mode and timing of delivery, obstetricians are also curious about uterine scar healing if the previous operation was a CS. Uterine scar thickness is an indicator of uterine scar healing. We aimed to evaluate the possible predictive value of striae gravidarum (SG) on IPA formation and uterine scar thickness (UST).

Methods: Fifty-five women with a previous CS history were evaluated for SG Davey Score. They were investigated for IPAs and lower segment uterine scar thickness during the current CS operation.

Results: Out of the patients with no SG (n = 11), mild SG (n = 10) and severe SG (n = 34), 1 (9.1%), 3 (30%) and 17 (50%) had IPA, respectively (p = 0.044). The mean uterine scar thicknesses in the no SG, mild SG and severe SG groups were 3.82 ± 4.04, 5.20 ± 4.13 and 5.18 ± 3.52, respectively (p = 0.561).

Conclusions: To the best of our knowledge, this was the first study to investigate the relationship between SG and IPA and uterine scar thickness. The SG status of a patient with a previous delivery and abdominal operation history might help predict IPA status before planning a new operation.

Keywords: Caesarean scar; intraabdominal adhesions; stretch marks.

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cicatrix / pathology*
  • Female
  • Humans
  • Pregnancy
  • Severity of Illness Index
  • Striae Distensae / epidemiology*
  • Tissue Adhesions / epidemiology*
  • Turkey / epidemiology
  • Uterus / pathology*