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Veronese S, Bacci PA, Garcia-Gimenez V, Canel Micheloud CC, Haro García NL, Sbarbati A. V-EMF therapy: A new painless and completely non-invasive treatment for striae gravidarum. J Cosmet Dermatol 2024; 23:2007-2014. [PMID: 38549181 DOI: 10.1111/jocd.16220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/06/2023] [Accepted: 01/29/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND The appearance of striae gravidarum (SG) during pregnancy is a common problem. The most common SG are abdominal striae, which can cause the greatest sequelae after pregnancy, and in the long term. There are several solutions to prevent and treat these striae, but not all are completely effective, and not without side effects. AIMS The aim of this study was to evaluate the effectiveness of a treatment that applies an electromagnetic field under vacuum (V-EMF therapy) on the abdominal SG. METHODS A retrospective analysis was conducted on the medical records of 26 women affected by abdominal SG and treated with V-EMF therapy. The results were evaluated using two different 5-point Likert Scales: one administered to the treated subjects to evaluate their satisfaction, and one to the doctors who performed the treatment, to evaluate the improvement of the striae. The presence of side effects, and the effects of sun exposure after treatment were also considered. RESULTS Only two treated subjects rated their level of satisfaction with a Score III on the Liker Scale. Everyone else expressed higher levels of satisfaction. Only one doctor rated the improvement of the striae with a Liker scale score of III. All the others reported greater improvements. No discomfort or side effects were noted either during the individual treatment sessions, or at the end of the treatment. The striae showed a newfound ability to tan. CONCLUSIONS V-EMF therapy proves to be a valid, safe, and effective treatment modality for SG.
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Affiliation(s)
- Sheila Veronese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Pier Antonio Bacci
- Medical Centre for Vascular Diseases and Aesthetic Pathologies, Arezzo, Italy
| | - Victor Garcia-Gimenez
- Knowledge and Management in Physiological Aging Medicine Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | | | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Yavuz O, Kurt S, Ozmen S, Bilen E, Akdöner A. Prediction of Intraperitoneal Adhesions in Repeated Cesarean Deliveries with Stria Gravidarum Scoring System: A Cross-sectional Study. Niger J Clin Pract 2024; 27:489-495. [PMID: 38679772 DOI: 10.4103/njcp.njcp_767_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/01/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health. AIM The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system. METHODS A total of 167 patients with at least one previous CD at or beyond 37 weeks of gestation were analyzed. Preoperative SG was calculated according to the Davey scoring system: 0-2 score were defined as mild SG (Group 1; n: 94, 56.2%), and 3-8 score were defined as severe SG (Group 2; n = 73, 43.8%). Preoperative previous cesarean incision features were evaluated according to the Vancouver scar scale. IPA was evaluated according to the Nair's and modified Nair's scoring systems. RESULTS Parity, younger age at first pregnancy, higher body mass index, number of previous CDs, rate of scar symptoms, Nair's and the modified Nair's scores were statistically significant in Group 2 (P = 0.01; P = 0.04; P = 0.007; P = 0.004; P < 0.001; P = 0.007; P = 0.02, respectively). Davey score ≥3 and Vancouver score ≥4.5 were determined as the cut-off value to predict IPA (P = 0.1 and 0.07, respectively). According to multivariate analysis, both Davey and Vancouver scores are independent factors in predicting IPA (P = 0.02 and 0.04, respectively). CONCLUSION Evaluating the SG score through the Davey score in women with a history of previous CD may assist in predicting IPA status before the planning of a subsequent surgery.
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Affiliation(s)
- O Yavuz
- Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - S Kurt
- Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - S Ozmen
- Department of Gynecology and Obstetrics, T.C. Sağlık Bakanlığı Karacabey Devlet Hastanesi, Bursa, Turkey
| | - E Bilen
- Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - A Akdöner
- Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Li M, Tian Y, Cheng R, Hao L. Clinical efficacy of stromal vascular fraction gel in the treatment of mature striae distensae. Skin Res Technol 2024; 30:e13551. [PMID: 38221781 PMCID: PMC10788582 DOI: 10.1111/srt.13551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Striae Distensae (SD) is a common dermatological lesion. The mechanism of formation is unclear, the prevailing theory is mechanical pulling of the skin and hormonal changes. Traditional SD treatment methods include topical drugs, photoelectric therapy, stripping and others, but each has limitations. Stromal vascular fraction gel (SVF-gel) is a filler physically prepared from granular fat, enriched with adipose-derived stem cells (ADSCs) and extracellular matrix (ECM). A good effect in the treatment of neck lines, wounds, acne, and other aspects. SD formation and treatment goals are comparable to those of neck lines. In this study, SVF-gel filling will be used to treat mature SD, and its effectiveness and safety will be discussed in detail. METHODS From December 2019 to June 2022, recruit patients who want to treat SD caused by obesity or pregnancy among those who have "autologous fat aspiration" to change their body shape. Preoperatively, the area to be treated for SD was marked, autologous fat aspiration was performed, and the aspirated fat was prepared as SVF-gel and filled into the preoperatively marked SD. All patients had preoperative and postoperative follow-up with planar photographs and VISIA skin analyzer photographs to assess surgical results and safety from subjective and objective perspectives. RESULTS A total of 36 patients were enrolled, with 31 of them successfully followed up on. The mean Global Aesthetic Improvement Scale (GAIS) score six months after surgery was 1.87 ± 0.03. At six months postoperatively, the overall patient satisfaction rate was 90%. The depth, area, and color of SD improved six months after surgery, and no serious complications occurred in any of the patients. CONCLUSIONS SVF-gel is a safe and effective method of improving mature SD and can be used as a clinical treatment option.
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Affiliation(s)
- Meijia Li
- Center of Plastic and Aesthetic Surgery of the First Affiliated Hospital of Harbin Medical UniversityHarbinPeople's Republic of China
| | - Yuan Tian
- Center of Plastic and Aesthetic Surgery of the First Affiliated Hospital of Harbin Medical UniversityHarbinPeople's Republic of China
| | - Rong Cheng
- Center of Plastic and Aesthetic Surgery of the First Affiliated Hospital of Harbin Medical UniversityHarbinPeople's Republic of China
| | - Lijun Hao
- Center of Plastic and Aesthetic Surgery of the First Affiliated Hospital of Harbin Medical UniversityHarbinPeople's Republic of China
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Shafti V, Azarboo A, Ghaemi M, Gargari OK, Madineh E. Prediction of intraperitoneal adhesions in repeated cesarean sections: A Systematic review and Meta-analysis. Eur J Obstet Gynecol Reprod Biol 2023; 287:97-108. [PMID: 37302234 DOI: 10.1016/j.ejogrb.2023.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/27/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE With the rate of repeated cesarean sections on the rise, intraperitoneal adhesions caused by repeated cesareans could give rise to maternal morbidity during delivery. As a result, it's critical to have the ability to predict adhesions. The current meta-analysis aims to determine if intraperitoneal adhesions are likely to be present based on the characteristics of the cesarean scar, striae gravidarum, and sliding sign. MATERIALS AND METHODS We systematically searched electronicdatabases beforeretrieving articles up until October 13th, 2022 for analysis. After data extraction and literature screening, we first performed a quality assessment using the QUADAS-2 score system. Following that, a bivariate random-effect meta-analysis model was used to obtain the combined diagnostic and predictive values. To pinpoint the origins of heterogeneity, we conducted a subgroup analysis. Fagan's Nomogram was used to validate the clinical utility. Sensitivity analysis was used to gauge the reliability of each included study, and Egger's test and funnel plot asymmetry was used to investigate publication bias. RESULTS 25 studies totaling 1840 patients with intra-abdominal adhesions and 2501 controls without adhesions were included in the systematic review. Diagnostic values from 8 studies regarding skin characteristics were combined, and the results for depressed scar showed: sensitivity[95 %CI] = 0.38[0.34-0.42]; Specificity[95 %CI] = 0.88[0.85-0.90]; DOR[95 %CI] = 4.78[2.50-9.13]; AUC = 0.65. Negative sliding sign from 7 studies, although not showing a diagnostic difference between cases and controls, had excellent predictive values: sensitivity[95 %CI] = 0.71[0.65-0.77]; Specificity[95 %CI] = 0.87[0.85-0.89]; DOR[95 %CI] = 6.88[0.6-78.9]; AUC = 0.77. Subgroup analysis illustrated non-Turkish studies to reveal more significant associations than Turkish studies. CONCLUSION Our meta-analysis found that the occurrence of adhesions can be predicted by the characteristics of abdominal wounds, particularly depressed scar, and scar width,as well as a negative sliding sign following a previous cesarean section.
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Affiliation(s)
- Vida Shafti
- School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
| | - Alireza Azarboo
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghaemi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Kohandel Gargari
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Erfan Madineh
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Aboshama RA, Taha OT, Abdel Halim HW, Elrehim EIA, Kamal SHM, ElSherbiny AM, Magdy HA, Albayadi E, Elsaid RE, Abdelghany AM, Anan MA, Abdelfattah LE. Prevalence and risk factor of postoperative adhesions following repeated cesarean section: A prospective cohort study. Int J Gynaecol Obstet 2023; 161:234-240. [PMID: 36200671 DOI: 10.1002/ijgo.14498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/12/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the prevalence of intraperitoneal adhesions after repeated cesarean delivery and its associated personal and surgical risk factors. METHODS This prospective cohort study was conducted at the delivery ward at Fayoum University Hospital from October 2020 to December 2021. Women were recruited according to predetermined inclusion and exclusion criteria. Eligible women were interviewed, and data were obtained for personal history, past surgical and obstetrical history, and data about the current delivery. Nair's scoring system was used to evaluate intraperitoneal adhesions. Postoperative data and complications were reported. RESULTS Three hundred women were recruited. Moderate to severe adhesions occurred in 186 patients (62%). These patients had a significantly prolonged hospital stay and were delivered by expert surgeons (P < 0.001 and P = 0.008, respectively). The adhesion score correlated positively with patients' age (P < 0.001), parity (P < 0.001), interpregnancy interval (P = 0.033), duration of hospital admission either previously or in the current delivery (P = 0.001 and P < 0.001), time to ambulation (P < 0.001), time to intestinal movement (P < 0.001), operative time (P < 0.001), and surgeons' age and experience (both P = 0.015). CONCLUSION Adhesions led to increased maternal morbidity. Multiple contributing factors were significantly related to adhesions with multiple cesarean deliveries.
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Affiliation(s)
| | - Omima T Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hala Waheed Abdel Halim
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman Ibrahim Abd Elrehim
- Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | | | - Hagar Abdelgawad Magdy
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eslam Albayadi
- Department of Anesthesia, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Rasha Ezzat Elsaid
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Amany Mohamed Abdelghany
- Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed A Anan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Laila Ezzat Abdelfattah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Türkmen H, Yörük S. Risk factors of striae gravidarum and chloasma melasma and their effects on quality of life. J Cosmet Dermatol 2023; 22:603-612. [PMID: 35037372 DOI: 10.1111/jocd.14783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aims to determine the risk factors associated with striae gravidarum (SG) and chloasma melasma (CM) and their effects on the quality of life. METHODS This descriptive and cross-sectional study was carried out in Turkey with 1000 pregnant women at 36 weeks of gestation and above. Personal information form, Quality of Life (SF36) Scale, Skindex-29 Scale, and MelasQoL-TR questionnaire were applied to pregnant women. Besides, skin types of pregnant women were determined using Fitzpatrick Skin Type Classification. Davey's score was used to determine the severity of SG. RESULTS In the study, the prevalence of SG was found as 67.9% (n = 679), and the prevalence of CM 23.5% (n = 235). There was a significant relationship between young age, low education level, high BMI before pregnancy, history of SG in her previous pregnancy, family history of SG, and development of SG in pregnant women (p = 0.001). There was a significant relationship between CM in her previous pregnancy and family history of CM and development of CM (p = 0.001). The quality of life of pregnant women with SG was found to be lower than without SG (p < 0.001). The quality of life of pregnant women with CM was found to be lower than without CM (p < 0.001). CONCLUSIONS As a result, in the study, it was determined that young age, low education level, high BMI, history of SG in previous pregnancy, and family history of SG were risk factors for SG. The risk factors of CM, on the other hand, were found as the history of CM in the previous pregnancy and the family. It was identified that SG and CM have adverse effects on the quality of life.
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Affiliation(s)
- Hülya Türkmen
- Department of Midwifery, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey
| | - Selda Yörük
- Department of Midwifery, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey
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Sönmez S, Akselim B, Karaşin SS. The effectiveness of preoperative diagnostic methods in predicting intra-abdominal adhesions before repeat cesarean section delivery. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221455. [PMID: 37075369 PMCID: PMC10176642 DOI: 10.1590/1806-9282.20221455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/20/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of skin appearance, striae gravidarum severity, and ultrasonographic "sliding sign" in predicting preoperative adhesions before repeat cesarean section delivery on the same patient and find the most useful one. METHODS This was a prospective cohort study conducted on pregnant women with a history of cesarean section delivery. Davey's scoring system was used for stria evaluation. The scar was assessed using their visual appearance, and transabdominal ultrasonography was applied to detect sliding sign existence. Surgeons blinded to preoperative assessment graded the severity of intra-abdominal adhesions intraoperatively using Nair's scoring system. RESULTS Of the 164 pregnant women with at least one previous cesarean section delivery, 73 (44.5%) had filmy or dense intra-abdominal adhesions. Statistically significant association was found between three groups regarding parity, previous cesarean number, scar appearance, total stria score, and sliding sign existence. Negative sliding sign had a likelihood ratio of 4.198 (95%CI 1.178-14.964) for the detection of intra-abdominal adhesions. Stria score and scar appearance were also valuable for detection adhesions with likelihood ratios of 1.518 (95%CI 1.045-2.205) and 2.405 (95%CI 0.851-6.796), respectively. After receiver operator characteristics curve analysis, striae score cutoff value in adhesion prediction was determined as 3.5. CONCLUSION Stria score, scar appearance, and sliding sign are all significant predictors for intraperitoneal adhesions, and sliding sign, as an easy-to-apply, inexpensive, useful sonographic marker, is the most effective adhesion predictor before repeat cesarean section delivery compared to other known adhesion markers.
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Affiliation(s)
- Seyhan Sönmez
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Obstetrics and Gynecology - Bursa, Turkey
| | - Burak Akselim
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Obstetrics and Gynecology - Bursa, Turkey
| | - Süleyman Serkan Karaşin
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Obstetrics and Gynecology - Bursa, Turkey
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Wu Y, Duan X, Gao Z, Yang N, Xue F. AICAR attenuates postoperative abdominal adhesion formation by inhibiting oxidative stress and promoting mesothelial cell repair. PLoS One 2022; 17:e0272928. [PMID: 36048820 PMCID: PMC9436141 DOI: 10.1371/journal.pone.0272928] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Postoperative abdominal adhesion is one of most common complications after abdominal operations. 5-aminoimidazole-4-carboxyamide ribonucleoside (AICAR) is an adenosine 5’-monophosphate activated protein kinase (AMPK) pathway agonist that inhibits inflammation, reduces cell fibrosis and cellular reactive oxygen species (ROS) injury, promotes autophagy and mitochondrial function. This study aimed to explore the mechanism of AICAR in inhibiting adhesion formation. Materials and methods Forty rats were randomly divided into five groups. All of the rats except the sham group received cecal abrasion to establish an adhesion model. The rats in the sodium hyaluronate group were treated with 2 mL sodium hyaluronate before closing the peritoneal cavity. The AICAR 1 and 2 groups were treated with 100 mg/kg and 200 mg/kg AICAR, respectively. Seven days after the operation, all of the rats were euthanized, and the adhesion condition was evaluated by Nair’s system. Inflammation was assessed by Eosin-hematoxylin (HE) staining and transforming growth factor-β (TGF-β1) detection. Oxidative stress effect was determined by ROS, nitric oxide (NO) level, superoxide dismutase (SOD), catalase, glutathione peroxidase (Gpx) and malondialdehyde (MDA) levels in adhesion tissue. Then, Sirius red picric acid staining was used to detect the fiber thickness. Immunohistochemical staining of cytokeratin-19 (CK-19), alpha-smooth muscle actin (α-SMA) and nuclear factor erythroid 2-related factor 2 (Nrf2) was also performed. Finally, HMrSV5 cells were treated with TGF-β1 and AICAR, the mRNA expression of E-cadherin, α-SMA and vimentin was assessed by q-PCR and cellular immunofluorescent staining. Results The rats in the AICAR-treated group had fewer adhesion formation incidences and a reduced Nair’s score. The inflammation was determined by HE staining and TGF-β1 concentration. The ROS, SOD, Catalase, Gpx, MDA levels and fiber thickness were decreased by AICAR treatments compared to the control. However, the NO production, Nrf2 levels and peritoneal mesothelial cell integrity were promoted after AICAR treatments. In vitro work, AICAR treatments reduced E-cadherin, α-SMA and vimentin mRNA level compared to that in the TGF-β1 group. Conclusion AICAR can inhibit postoperative adhesion formation by reducing inflammation, decreasing oxidative stress response and promoting peritoneal mesothelial cell repair.
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Affiliation(s)
- Yunhua Wu
- The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Xianglong Duan
- The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Affiliated Hospital of Northwestern Polytechnical University, Xi’an, Shaanxi, China
| | - Zengzhan Gao
- The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Ni Yang
- The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Fei Xue
- The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Affiliated Hospital of Northwestern Polytechnical University, Xi’an, Shaanxi, China
- * E-mail:
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Suzuki N, Wakaki Y, Watanabe K, Kumasaka Y, Suzuki R. Difficulty in predicting intra‐abdominal adhesion before cesarean section: A case report. Clin Case Rep 2022; 10:e05643. [PMID: 35356188 PMCID: PMC8958188 DOI: 10.1002/ccr3.5643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
Severe adhesions between the bladder and uterus necessitated an atypical incision in the cesarean section of a woman with endometriosis. This could not be predicted with pre‐surgery MRI. No methods in the literature are able to predict adhesions with true certainty; it is therefore still difficult to diagnose intra‐abdominal adhesions.
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Affiliation(s)
- Nanao Suzuki
- Department of Obstetrics and Gynecology Ohara General Hospital Fukushima Japan
| | - Yu Wakaki
- Department of Obstetrics and Gynecology Ohara General Hospital Fukushima Japan
| | - Kaori Watanabe
- Department of Obstetrics and Gynecology Ohara General Hospital Fukushima Japan
| | - Yukiko Kumasaka
- Department of Radiology Ohara General Hospital Fukushima Japan
| | - Rika Suzuki
- Department of Obstetrics and Gynecology Ohara General Hospital Fukushima Japan
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Elprince M, Taha OT, Ibrahim ZM, Khamees RE, Greash MA, Atwa KA, Gadallah AM, Al-Okda N, Abdel Aal RM, Ibrahim MF, Aboelroose AA, Ashour OE, Elgedawy AM, Elbahie AM, Ghoneim HM, Ahmed AA. Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections. BMC Pregnancy Childbirth 2021; 21:286. [PMID: 33836692 PMCID: PMC8033650 DOI: 10.1186/s12884-021-03763-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions. METHODS This was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey's scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair's scoring system was used to evaluate intraperitoneal adhesions. RESULTS The study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value < 0.001). Higher scores for the parameters of the Vancouver scale were present in patients with severe striae (1.69 ± 1.01, 1.73 ± 0.57, 2.67 ± 1.23, and 1.35 ± 1.06 for scar vascularity, pigmentation, pliability, and height respectively with a p-value of < 0.001 each). Thick intraperitoneal adhesions were noted significantly in women with severe striae [21 (43.75%), p-value < 0.001)]. The Davey's and Vancouver scores showed highly significant predictive performance in the prediction of intraperitoneal adhesions (p-value < 0.001). CONCLUSION Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.
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Affiliation(s)
- Mohamed Elprince
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Omima T Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Zakia M Ibrahim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Rasha E Khamees
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mahmoud A Greash
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Khaled A Atwa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed M Gadallah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Noha Al-Okda
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Radwa M Abdel Aal
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mohamed F Ibrahim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed A Aboelroose
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Osama E Ashour
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Asmaa M Elgedawy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Amira M Elbahie
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hanan M Ghoneim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Amal A Ahmed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Abbas AM, Khalaf M, Abdel-Reheem F, El-Nashar I. Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: A cross-sectional study. J Gynecol Obstet Hum Reprod 2019; 49:101619. [PMID: 31430563 DOI: 10.1016/j.jogoh.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate the predictive value of the Davey Score for striae gravidarum (SG) on the presence of pelvic adhesions at repeat cesarean delivery (CD). MATERIALS AND METHODS The current study was a cross-sectional study conducted in a tertiary university hospital between November 2016 and March 2018. All women scheduled for elective CD were included if they had at least previous one CD with pregnancy in term fetus (37-40 weeks gestation. Preoperative evaluation of SG severity using Davey score, which is a validated scoring system, was done on the examination bed. Patients with no/mild striae (score 0-2) were classified as group (I) and women with severe striae (score 3-8) were classified as group (II). During surgery, pelvic adhesions were evaluated and classified according to the Nair's scoring system. The primary outcome was the difference in the rate of pelvic adhesions between both groups. RESULTS The study included 300 women; group I included 114 women and group II included 186 women. About 90% of women with severe striae versus 82.5% of women with no/mild striae were found to have adhesions (p = 0.035). Dense adhesions were significantly present in severe striae group (57.4%) versus (41.5%) in no/mild striae group (p = 0.022). The mean Davey score in women in group (II) was significantly higher than group (I) (4.25 ± 3.36 vs. 3.09 ± 2.95, p = 0.03). Nair's score had a significant positive moderate correlation with Davey score (r = 0.541, p = 0.016). According to the results of multivariate regression analysis, Davey score >2 was the only variable associated with increased risk of pelvic adhesions (p = 0.010). CONCLUSION Assessment of SG score in women with previous CD using Davey score might help to predict pelvic adhesions status before planning a new surgery.
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Affiliation(s)
- Ahmed M Abbas
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt.
| | - Mohammed Khalaf
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
| | - Fatma Abdel-Reheem
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
| | - Ihab El-Nashar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
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Celik EY, Ersoy AO, Ersoy E, Yoruk O, Tokmak A, Tasci Y. Is Striae Gravidarum related to Cesarean Scar and Peritoneal Adhesions? Pak J Med Sci 2018; 34:568-573. [PMID: 30034417 PMCID: PMC6041520 DOI: 10.12669/pjms.343.14288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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).
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Affiliation(s)
- Esra Yasar Celik
- Esra Yasar Celik, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care Training and Research Hospital, Ankara, Turkey
| | - Ali Ozgur Ersoy
- Ali Ozgur Ersoy, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care Training and Research Hospital, Ankara, Turkey
| | - Ebru Ersoy
- Ebru Ersoy, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care Training and Research Hospital, Ankara, Turkey
| | - Ozlem Yoruk
- OzlemYoruk, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care Training and Research Hospital, Ankara, Turkey
| | - Aytekin Tokmak
- AytekinTokmak, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care Training and Research Hospital, Ankara, Turkey
| | - Yasemin Tasci
- YaseminTasci, Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care Training and Research Hospital, Ankara, Turkey
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Hu M, Miao C, Wang X, Ma Y. Robotic surgeries for patients with colorectal cancer who have undergone abdominal procedures: Protocol for meta-analysis. Medicine (Baltimore) 2018; 97:e0396. [PMID: 29642201 PMCID: PMC5908641 DOI: 10.1097/md.0000000000010396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although the safety and the advantages of laparoscopic and robotic colorectal surgeries have been confirmed, the use of both modalities in patients with previous abdominal surgeries (PAS) history remains uncertain. Herein, we perform a meta-analysis to investigate the impact of PAS on perioperative recovery outcomes from laparoscopic and robotic colorectal surgeries. METHODS We will search PUBMED, the Cochrane Library, the Chinese Biomedical database (CBM), WanFang data, China National Knowledge Infrastructure (CNKI) up to January 2018. Studies will be screened by title, abstract, and full text independently and in duplicate. Studies that report the impact of PAS on perioperative recovery outcomes from laparoscopic and robotic colorectal surgeries will be eligible for inclusion. Outcome variables will be assessed included combined resection, conversion, operation time, blood loss, number of retrieved lymph nodes, days to soft diet intake, length of hospital stay, and postoperative complications. Assessment of risk of bias and data synthesis will be performed using STATA SE 12.0. Heterogeneity among studies will be assessed using the I statistic. RESULTS Randomized controlled trials, prospective cohort studies, and propensity-matched comparative studies will be used for the quantitative synthesis of the meta-analysis to evaluate the impact of PAS on perioperative recovery outcomes from laparoscopic and robotic colorectal surgeries. CONCLUSIONS We aim to draw an objective conclusion of the comparisons in aspects of perioperative outcomes and provide physicians level I evidences for clinical decision makings.
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