Operative Obstetrics
Poster Session 2
Or Lee Rak, MD (she/her/hers)
Helen Schneider Hospital for Women, Rabin Medical Center
Ramat Hasharon, HaMerkaz, Israel
Daniela Chen, BSc, MD
Helen Schneider Hospital for Women, Rabin Medical Center
Petach-Tikva, HaMerkaz, Israel
Raud Qassim, BS, MD
Meir Medical Center
Technion, Hefa, Israel
Naama Golan, MD
Rabin Medical Center
Petach-Tikva, HaMerkaz, Israel
Eran Hadar, Prof.
Rabin Medical Center
Petach-Tikva, HaMerkaz, Israel
Cesarean delivery (CD) poses a risk of intra-abdominal adhesions, leading to various complications. We aimed to investigate the association between skin scar characteristics and subcutaneous and intra-abdominal adhesions in order to improve preoperative assessment.
Study Design:
Consecutive consenting pregnant women scheduled for elective repeat CD were prospectively recruited between February and July 2023. Detailed demographic, medical, obstetric, and gynecological information was collected, along with information of previous and current CD. Skin scar appearance was evaluated on admission using the validated Vancouver and Stony Brook Scar Scales. Intra-abdominal adhesions were assessed intraoperatively using the Modified Nair's scoring system. We analyzed the correlation between cutaneous scar scoring, subcutaneous/intra-abdominal adhesion scores and surgery length.
Results:
One hundred and eleven women were recruited. Participants had one (41.4%), two (42.3%) or 3 and more (16.2%) previous CDs. Mean maternal age was 35.6±5.1, median body mass index (BMI) was 24.5 (16.9-60.2) kg/m² and median gestational age at surgery was 38+3 (36+3-41+0) weeks. The average surgery length was 49.1±15.1 minutes.
The mean Vancouver Scar Scale and Stony Brook Scar Scale scores were 4.12 (±3.15) and 3.02 (±1.77), respectively. These scores showed weak but significant correlations with both intra-abdominal adhesion score (Spearman's rho = 0.24, p= 0.012 and Spearman's rho = - 0.23, p= 0.015, respectively) and subcutaneous adhesion score (Spearman's rho = 0.24, p= 0.012 and Spearman's rho = - 0.22, p = 0.018, respectively). No significant correlation was found between these scar scales and surgery length.
Conclusion: This prospective study highlights the importance of cutaneous scar characteristics in predicting subcutaneous and intra-abdominal adhesions during repeat CDs. We found weak but significant correlation between scar characteristics and subcutaneous and intra-abdominal adhesions. Healthcare professionals can use this knowledge to tailor surgical approaches, particularly in cases with limited surgical history.