Predictions of intra-abdominal adhesions using ultrasonography and birth outcomes among term pregnant mothers with previous scar attending antenatal clinic at Mnazi Mmoja referral hospital, Zanzibar
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Date
2024
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Kairuki University
Abstract
Introduction: Intra-abdominal adhesions represent a major concern in the obstetrical ward due to the increased morbidity and mortality from both mother and neonates during caesarian section. This study aimed to determine the proportion of intraabdominal adhesion and their patterns using Ultrasonography sliding sign among term pregnant women with previous scars attending MMRH. In addition, the study aimed to determine the correlation between intra-abdominal adhesion and birth outcomes.
Methods: This study employed a prospective cohort study involving interviews, medical
record reviews, preoperative assessment of intraabdominal adhesion using Ultrasonography sliding sign, and post-partum followup of both mother and neonate. Descriptive statistics, chi-square analysis and logistic regression were used for data analysis.
Results: The study found the proportion of intra-abdominal adhesion at 81(47.1%). Moderate adhesion were the most prevalent 61(35.5%) and 20(11.6 %) of patients also had severe adhesion. Occurrence of birth asphyxia (Apgar<7) was significantly associated with the presence of intra-abdominal adhesion. The overall sensitivity and specificity of the USS ultrasonography scan were 48% and 68%, respectively. USS was more sensitive and specific to predict severe adhesion respectively in 83.3% and 100%.
Conclusion: The proportion of intra-abdominal adhesions assessed using ultrasonography sliding sign among pregnant women with previous scars attending MMRH was relatively high compared to that reported in different literature. Moderate adhesions were the most prevalent form observed. However, USS had high accuracy in predicting severe intraabdominal adhesions with high sensitivity and specificity. There was a strong correlation between a low Apgar score and the presence or absence of intra-abdominal adhesions.
Description
Dissertation submitted to the Faculty of Medicine in partial fulfillment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology of Kairuki University
Keywords
adverse neonatal outcomes, intraabdominal adhesion, ultrasonography sliding sign
Citation
Darwesh, Chausiku J., 2024. Predictions of intra-abdominal adhesions using ultrasonography and birth outcomes among term pregnant mothers with previous scar attending antenatal clinic at Mnazi Mmoja referral hospital, Zanzibar. Dissertation. Kairuki University