The Value of Ultrasonographic Sliding Sign in Prediction of Intra-Abdominal Adhesions in Pregnant Women Undergoing Cesarean Section Following Abdominopelvic Surgery: A Prospective Study

Darweesh, FF; Hussein, Gamal Oma Abdelghany; Abdelmoety, Ghada Abdelfatah; El Sharkawy, Mohamed; Latif, Dina

doi:10.21608/egyfs.2025.409770

The Value of Ultrasonographic Sliding Sign in Prediction of Intra-Abdominal Adhesions in Pregnant Women Undergoing Cesarean Section Following Abdominopelvic Surgery: A Prospective Study

Document Type : Original Article

Authors

Department of obstetrics and gynecology , Cairo university, Cairo, Egypt

10.21608/egyfs.2025.409770

Abstract

Objective: The current evidence is inconclusive regarding the utility of sliding sign for prediction of intra-abdominal adhesion. In the present study, we assessed the diagnostic accuracy of negative sliding sign for prediction of intra-abdominal adhesion in pregnant women scheduled for Cesarean section (CS) and had a history of previous abdominopelvic surgery.
Methods: A prospective, observational, study was conducted on 158 full-term pregnant women who were candidates for elective cesarean section.
Results: A total of 16 (10.2%) women had negative sliding sign and 8.9% had marked adhesions. The positive sliding sign accurately detected 138 (95.8%) out of 144 patients with no or minor adhesions, while the negative sliding sign correctly recognized 10 (71.4%) out of 14 patients with signiﬁcant adhesions during the CS treatment. The sliding sign demonstrated a sensitivity of 71.4%, speciﬁcity of 95.8%, positive predictive value (PPV) of 62.5%, and negative predictive value (NPV) of 97.1% in predicting signiﬁcant intra-operative adhesions. In contrast, patients who did not exhibit a sliding sign had a higher probability of suffering from intra-operative bleeding, a signiﬁcant decrease in hemoglobin levels of more than 3 g/dl, visceral injury, and a longer delivery time (p <0.001).
Conclusion: In conclusion, our ﬁndings highlight that the negative sliding sign can be used for prediction of severe intra-abdominal adhesions; the negative sliding sign is an accurate, reproducible, and easily accessible method for prediction of adhesions in clinical setting. Moreover,patients with negative sliding sign appears to have higher risk of prolonged delivery, intra-operative bleeding, and visceral injury.

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