Background: Adhesions during repeat cesarean sections increase surgical difficulty, risk of visceral injury, operative time, and blood loss.A reliable, non-invasive method to predict adhesions preoperatively can improve surgical planning and outcomes.Objectives: To evaluate the diagnostic accuracy of the ultrasound-based sliding sign in predicting the presence and severity of intraoperative adhesions in repeat cesarean sections and its association with surgical outcomes.Materials and methods: This cross-sectional study was conducted over one year (June 2023-May 2024) at Sawai Man Singh Medical College, Jaipur, including 100 pregnant women undergoing repeat cesarean section.The uterine sliding sign was assessed preoperatively via transabdominal ultrasound and categorized as: >2 cm, 1-2 cm, or 2 cm predicted the absence of significant adhesions with 100% sensitivity, 98.9% specificity, 97.2% PPV, and 100% NPV.Patients with restricted or absent sliding sign had significantly longer operative times (63.00 3.50 min), greater hemoglobin drop (1.21 0.26 gm/dL), and higher visceral injury rates (50%) (p < 0.001). Conclusion:The sliding sign is a simple, non-invasive, and highly accurate tool for predicting intraoperative adhesions in repeat cesarean sections, aiding in surgical preparedness.Clinical significance: Routine use of the ultrasound sliding sign in preoperative assessment can enhance safety and guide operative planning in repeat cesarean sections.
Jain et al. (Fri,) studied this question.