Diagnostic Accuracy of Abdominal Ultrasonographic Sliding Sign in the Evaluation of Severe Intra-Abdominal Adhesions Involving the Uterus in Women Undergoing Repeat Caesarean Delivery: Systematic review and meta-analysis

Authors

Amira M. Taha, Faculty of Medicine, Fayoum University, Fayoum, Egypt
Wesam A. Moawad, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt; AND Medical Agency for Research and Statistics, London, UK
Sara A.A. Saed, Department of Clinical Pharmacy, Ministry of Health, Egypt; AND Medical Agency for Research and Statistics, London, UK
Tala J. Alhejazi, Faculty of Medicine, Aleppo University, Aleppo, Syria
Youstina A. Sabri, Faculty of Medicine, Fayoum University, Fayoum, Egypt
Mohamed Abd-ElGawad, Faculty of Medicine, Fayoum University, Fayoum, Egypt
Juan L. Alcazar, Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
Nihal Al Riyami, Department of Obstetrics & Gynecology, Sultan Qaboos University, Muscat, Oman
Ayatallah Khafagy, StoneSprings Obgyn, Dulles, Virginia, USA
Yasmine A. Mohammed, Faculty of Medicine, Assiut University, Assiut, Egypt
Ahmed H. Saad, Department of Obstetrics and Gynecology, Cairo University, Cairo, EgyptFollow

Abstract

This review aimed to assess diagnostic accuracy of transabdominal ultrasonography (TAS) sliding sign in diagnosing severe intra-abdominal adhesions with repeated Caesarean delivery (CD). PubMed, Google Scholar, Web of Science and Scopus were searched for published studies until October 2022. Studies evaluating the sliding sign as a predictor of intra-abdominal adhesions after repeat CD were included. STATA and Comprehensive Meta-Analysis for meta-analysis was used. A total of 7 studies (1,318 patients) were included. For identifying severe intra-abdominal adhesions, sliding sign on TAS had a combined sensitivity (64%, 95% confidence interval [CI]: 55-71%), specificity (93%, 95% CI: 89-96%), positive likelihood ratio (9.5, 95% CI: 5.7-16), negative likelihood ratio (0.39, 95% CI: 0.31-0.49) and diagnostic odds ratio (24, 95% CI: 13-46). Prediction intervals for sensitivity and specificity were 0.444-0.786 and 0.711-0.985, respectively. Sliding sign on TAS is a simple, non-invasive, good negative and practical method to exclude severe intra-abdominal adhesions involving the uterus with low sensitivity and high specificity.

Publication Date

3-20-2025

First Page

29

Last Page

37

Creative Commons License

This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 International License.

Recommended Citation

Taha, Amira M.; Moawad, Wesam A.; Saed, Sara A.A.; Alhejazi, Tala J.; Sabri, Youstina A.; Abd-ElGawad, Mohamed; Alcazar, Juan L.; Riyami, Nihal Al; Khafagy, Ayatallah; Mohammed, Yasmine A.; and Saad, Ahmed H. (2025) "Diagnostic Accuracy of Abdominal Ultrasonographic Sliding Sign in the Evaluation of Severe Intra-Abdominal Adhesions Involving the Uterus in Women Undergoing Repeat Caesarean Delivery: Systematic review and meta-analysis," Sultan Qaboos University Medical Journal: Vol. 25: 29-37.
DOI: https://doi.org/10.18295/squmj.10.2024.063