title: A reliable way to predict intraabdominal adhesions at repeat cesarean delivery: scar characteristics.
abstract: OBJECTIVE
  To evaluate association between scar characteristics and intraabdominal adhesions at repeat cesarean delivery.
  
  
  METHODS
  A prospective, cross-sectional study.
  
  
  METHODS
  Tertiary Government Maternity Training Hospital in Ankara, Turkey.
  
  
  METHODS
  295 pregnant women with at least one prior cesarean delivery.
  
  
  METHODS
  All women were at least 36 weeks pregnant. Appearance of previous cesarean delivery scars was categorized into three groups - flat, depressed and elevated. Pigmentation status was also noted (non-pigmented or pigmented).
  
  
  METHODS
  Intraoperatively detected adhesions, evaluated and classified into three groups (no adhesion, filmy adhesion and dense adhesion groups) by a modified Nair's classification.
  
  
  RESULTS
  Elevated scars had significantly more dense adhesion formation than depressed ones (31.4 vs. 12.7%, p=0.02). No difference was found for dense adhesions when depressed and flat scars were compared (12.7 vs. 6.8%, p=0.124). Of flat scars, 93.2% were free of dense adhesions. Pigmented scars had more dense adhesions than non-pigmented (26.6 vs. 9.3%, p<0.01). Using logistic regression analysis scar length, scar width and appearance of scar (flat or non-flat) were directly related to adhesion formation.
  
  
  CONCLUSIONS
  There is an association between scar type and adhesions, particularly for hypertrophic scars and dense adhesions.
authors.affiliation: Zekai Tahir Burak Maternity Hospital, Ankara, Turkey. nasuhutkudogan@yahoo.com
authors.forename: Nasuh U
authors.initials: NU
authors.lastname: Dogan
authors.forename: Seval A
authors.initials: SA
authors.lastname: Haktankacmaz
authors.forename: Selen
authors.initials: S
authors.lastname: Dogan
authors.forename: Ozlenen
authors.initials: O
authors.lastname: Ozkan
authors.forename: Hatice
authors.initials: H
authors.lastname: Celik
authors.forename: Ozlem G
authors.initials: OG
authors.lastname: Eryilmaz
authors.forename: Melike
authors.initials: M
authors.lastname: Doganay
authors.forename: Cavidan
authors.initials: C
authors.lastname: Gulerman
mesh_terms: D034841:Abdominal Cavity / Q000473:pathology*; D000328:Adult; D017604:Cesarean Section, Repeat; D002921:Cicatrix / Q000473:pathology*; D017439:Cicatrix, Hypertrophic / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000473:pathology*; D014421:Turkey