Abstract
Objective:To evaluate the relationship between striae gravidarum (SG) score and abdominal scar characteristics together with intraperitoneal adhesion (IPA) grades of patients who were hospitalized for second cesarean delivery.Methods:A total of 145 consecutive women undergoing scheduled cesarean section (CS) in a tertiary level maternity hospital between November 2013 and January 2014 were included in the study. All women had transverse suprapubic skin incision due to the previous CS and none of them had a history of vaginal delivery. Patients were classified according to the SG status, as women with no SG: Group-1(n=53), mild SG: Group-2(n=27) and severe SG: Group 3(n=65). Groups were compared between themselves with regard to various sociodemographic properties, cesarean scar characteristics and IPA scores.Results:No significant difference in the length, width and color of the scar was detected among groups. While flat scar was the most prominent form of scar, the elevated scar was significantly more frequent in Group-1 compared to other groups (p=0.009). IPA grades were 0 or 1 in 77.3% of Group-1, 81.3% of Group-2 and 76% of Group-3. There was no significant difference in IPA scores between groups (p=0.884). After combining CS scar characteristics (flat, depressed and elevated) and SG status [SG (+) or SG (-)], we found no significant difference between the groups in terms of IPA severity.Conclusion:Striae gravidarum (SG) was found to be associated with scar characteristics, but not associated with the severity of intraperitoneal adhesion (IPA).
Highlights
Striae gravidarum (SG, called’ striae distensae’) is a common condition observed in pregnancy to various extents
It is very difficult to predict the presence of intraperitoneal adhesions (IPA) and whether complications will develop in patients who have undergone previous abdominal surgery
One hundred forty five consecutive women hospitalized for Cesarean section (CS) between November 2013January 2014 were included in the present cross sectional study, each having one previous CS history with low segment transverse skin incision, with no vaginal delivery history.Approval from the Institutional Review Board of the Zekai Tahir Burak Women’s Health Care Training and Research Hospital (Approval Date/Number: 23.08.2013/19) and written informed consent from all participants were obtained before recruiting patients for the study
Summary
Striae gravidarum (SG, called’ striae distensae’) is a common condition observed in pregnancy to various extents. Cesarean section (CS) is one of the most common operation performed worldwide which carries the potential risk of serious complications due to the intraperitoneal adhesions, such as bladder and bowel injury, infertility or chronic pelvic pain.[7,8,9] It is very difficult to predict the presence of intraperitoneal adhesions (IPA) and whether complications will develop in patients who have undergone previous abdominal surgery. There is no reliable way to predict the severity and extent of adhesions prior to repeat surgeries
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