{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:41:07Z","timestamp":1787618467144,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,11,5]],"date-time":"2018-11-05T00:00:00Z","timestamp":1541376000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Intra\u2010abdominal adhesions are associated with an increased risk of complications during repeat Cesarean section (CS), such as bladder and bowel injury, hemorrhage, infection and hysterectomy. We present a simple sonographic marker, the \u2018sliding sign\u2019 of the uterus, for the prediction of intra\u2010abdominal adhesions in the third trimester of pregnancy in women undergoing repeat CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of pregnant women with a history of at least one Cesarean delivery evaluated by transabdominal ultrasound during the third trimester of an ongoing pregnancy. In order to diagnose intra\u2010abdominal adhesions, we assessed a sonographic sign, the sliding of the uterus under the inner part of the fascia of the abdominal muscles during deep breathing. Women were considered to be at high risk for severe adhesions if uterine sliding was absent and at low risk in the presence of obvious or moderate uterine sliding. A comparison between sonographic findings and intra\u2010abdominal adhesions observed during surgery was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 63 patients with one or more previous CS examined, 59 completed the study and underwent CS at our institution. In 16 of the 19 cases assigned to the high\u2010risk group for severe adhesions due to absence of sliding of the uterus, the suspicion was confirmed at surgery. The prediction of low risk for adhesions was confirmed in 35 out of 40 patients. The sensitivity and specificity of the sliding sign in predicting presence of intra\u2010abdominal adhesions in women undergoing repeat CS were 76.2% and 92.1%, respectively. Inter\u2010 and intraobserver correlation using Cohen's kappa coefficient were 0.52 and 0.77, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data show that a simple sonographic sign might be able to discriminate between high and low risk for intra\u2010abdominal adhesions in patients with a history of Cesarean delivery. This technique may aid clinical decisions in patients undergoing repeat CS. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19057","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T13:23:44Z","timestamp":1521984224000},"page":"662-665","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Sliding sign in third\u2010trimester sonographic evaluation of intra\u2010abdominal adhesions in women undergoing repeat Cesarean section: a novel technique"],"prefix":"10.1002","volume":"52","author":[{"given":"J.","family":"Baron","sequence":"first","affiliation":[{"name":"US Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center Ben Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Tirosh","sequence":"additional","affiliation":[{"name":"US Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center Ben Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1522-8732","authenticated-orcid":false,"given":"S. A.","family":"Mastrolia","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine, Fondazione MBBM San Gerardo Hospital, University of Milano Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Ben\u2010Haroush","sequence":"additional","affiliation":[{"name":"US Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center Ben Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"US Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center Ben Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Kerner","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering and Management Ben Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hershkovitz","sequence":"additional","affiliation":[{"name":"US Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center Ben Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,5]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"1","article-title":"Births: Final data for 2015","volume":"66","author":"Martin JA","year":"2017","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.04.039"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.12.017"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02965.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/gyn.2007.B-02283-1"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17465"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1176135"},{"key":"e_1_2_5_9_1","first-page":"251","article-title":"Clinical profile of patients with postoperative adhesive intestinal obstruction and its association with intraoperative peritoneal adhesion index","volume":"111","author":"Sisodia V","year":"2016","journal-title":"Chirurgia (Bucur)"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2009.03.023"},{"key":"e_1_2_5_11_1","unstructured":"Centers for Disease Control and Prevention (CDC). 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