Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT06023381 |
Other study ID # |
Sliding Sign |
Secondary ID |
|
Status |
Completed |
Phase |
|
First received |
|
Last updated |
|
Start date |
October 1, 2022 |
Est. completion date |
July 1, 2023 |
Study information
Verified date |
September 2023 |
Source |
Ain Shams Maternity Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
Predicting the presence of severe adhesions may also assist clinically in several ways:
first, it allows allocation of more complicated surgeries to experienced surgeons; second,
the surgeons can plan and prepare better for the surgery if they know in advance whether they
are going to operate a complicated surgery; third, a difficult surgery may be scheduled to be
performed in an experienced center, preparing cross match blood units, and alerting the
general surgeon and urologist of the potential risk for surgical complications, saving time
if intervention is required.
This information can permit preoperative planning by a multidisciplinary team of surgeons and
allow the patient to be informed of the potentially high risk of complications.
Description:
The incidence of repeat cesarean delivery is on the rise worldwide, approximately 90% of
women with a prior cesarean delivery undergo a planned repeat cesarean delivery in their next
pregnancy.
Post-cesarean adhesions are a major complication in subsequent surgeries, causing an
increased risk for bladder and bowel injury (0.1-0.3%), hemorrhage (0.1-1.4%), infection
(0.4-1.6%), and even hysterectomy (0.1-1.4%).
In addition to the risk associated with the pelviabdominal surgical procedure itself,
adhesiolysis may result in injury to adjacent viscera, blood loss, and in case of emergency
cesarean delivery, to the perinatal adverse outcome associated with delayed delivery of the
neonate. This represents a considerable healthcare issue, as it has a significant impact both
on the patient, increasing morbidity and mortality, and on healthcare costs. It is therefore
important for surgeons to detect patients at high risk of having adhesions.
Women suspected to have severe intra-abdominal adhesions may benefit from appropriate
preparation of blood products, better assignment of surgeons, request for preoperative
surgical assistance of other medical specialties, and possibly performance of a midline skin
incision to enter the peritoneal cavity. It is therefore important for surgeons to detect
patients at high risk of having adhesions.
Various means have been proposed to predict adhesions prior to surgery, including analysis of
patient characteristics and appearance of the scar, as well as the intraoperative peritoneal
adhesion index.