Abstract:
BACKGROUND AND OBJECTIVE:
Caesarean section (CS) is a common obstetric procedure, with repeat CS
increasing the risk of intra-abdominal adhesions, leading to surgical
complications. The ultrasound sliding sign has been proposed as a non-invasive
tool to predict adhesions, but its diagnostic accuracy remains under evaluation.
This study aims to assess the accuracy of the ultrasound sliding sign in predicting
intra-abdominal adhesions in repeat CS cases and evaluate its correlation with
intraoperative findings.
MATERIAL AND METHODS:
A prospective observational study was conducted at BLDE (D.U) Shri B.M. Patil
Medical College from May 2023 to December 2024, including 200 women
undergoing repeat CS. Preoperative ultrasound evaluated the sliding sign,
classifying cases as positive (free uterine movement, no adhesions) or negative
(restricted movement, adhesions). Intraoperative findings were recorded for
correlation. Statistical analysis was performed using IBM SPSS (Version 20).
RESULTS:
Among the participants, 40% had adhesions. The ultrasound sliding sign
demonstrated 86.1% sensitivity, 85.8% specificity, 77.5% PPV, and 91.6% NPV.
Adhesions were significantly associated with maternal age (>30 years), parity
(≥2), higher BMI, and multiple previous CS. ROC analysis confirmed the strong
predictive value of the sliding sign.
CONCLUSION:
The ultrasound sliding sign is a reliable, non-invasive tool for predicting
intraabdominal adhesions in repeat CS, aiding in surgical preparedness. Given its
high diagnostic accuracy, it can enhance clinical decision-making, but further
studies are needed to refine its application.
