Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery

Şule Gül Aydın; Gülsüm Uysal; Eda Nur Koyuncuoğlu; Sefa Arlıer

doi:10.32322/jhsm.2013560

Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery

Abstract

Aims: Repeated cesarean deliveries are associated with intra-abdominal adhesions and pelvic anatomical distortion. This study evaluated vesicouterine thickness and its association with intraoperative adhesions compared with females undergoing their first cesarean delivery. Methods: This prospective observational study included 117 term pregnant female who underwent cesarean delivery between January and June 2024. Sixty-four female with at least one previous cesarean delivery comprised the previous CD group, while 53 females undergoing their first cesarean delivery comprised the primary CD group. Preoperative ultrasonographic evaluation included transvaginal measurement of vesicouterine thickness. Intraoperative adhesions were graded using the Nair adhesion scoring system. Correlation and receiver operating characteristic (ROC) analyses were performed. Results: Vesicouterine thickness was significantly lower in the previous CD group than in the primary CD group [4 (2-6) mm vs. 5 (3-7) mm, p<0.001]. Intra-abdominal adhesions were significantly more frequent in the previous CD group (p<0.001). A significant inverse correlation was observed between the number of previous cesarean deliveries and vesicouterine thickness (r=-0.631, p<0.001). ROC analysis showed limited discriminatory performance of vesicouterine thickness for identifying adhesions (AUC=0.688, p=0.155). Conclusion: Previous cesarean delivery was associated with reduced vesicouterine thickness and increased intra-abdominal adhesions. Although vesicouterine thickness showed limited discriminatory ability as a standalone predictor of intra-abdominal adhesions, it may reflect cesarean-related pelvic tissue remodeling and could potentially provide complementary information when combined with other preoperative markers.

Keywords

Supporting Institution

None

Ethical Statement

This study was approved by the Clinical Research Ethics Committee of Adana City Training and Research Hospital, University of Health Sciences (Approval No. 3015, December 2023). Written informed consent was obtained from all participants.

Thanks

None

References

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Şule Gül Aydın ^*
0000-0001-8307-9153
Türkiye

Gülsüm Uysal
0000-0002-9381-4892
Türkiye

Eda Nur Koyuncuoğlu
0009-0008-7602-7396
Türkiye

Sefa Arlıer
0000-0002-0019-8403
Türkiye

Publication Date

October 25, 2026

Submission Date

August 8, 2026

Acceptance Date

October 20, 2026

Published in Issue

Year 2026 Volume: 9 Number: 6

DOI

https://doi.org/10.32322/jhsm.2013560

IZ

https://izlik.org/JA38YL66XM

Cite

RIS / Bibtex

APA

Gül Aydın, Ş., Uysal, G., Koyuncuoğlu, E. N., & Arlıer, S. (2026). Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery. Journal of Health Sciences and Medicine, 9(6), 1887-1893. https://doi.org/10.32322/jhsm.2013560

AMA

1.Gül Aydın Ş, Uysal G, Koyuncuoğlu EN, Arlıer S. Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery. J Health Sci Med / JHSM. 2026;9(6):1887-1893. doi:10.32322/jhsm.2013560

Chicago

Gül Aydın, Şule, Gülsüm Uysal, Eda Nur Koyuncuoğlu, and Sefa Arlıer. 2026. “Preoperative Ultrasonographic Assessment of Vesicouterine Thickness and Its Relationship With Intra-Abdominal Adhesions at Repeat Cesarean Delivery”. Journal of Health Sciences and Medicine 9 (6): 1887-93. https://doi.org/10.32322/jhsm.2013560.

EndNote

Gül Aydın Ş, Uysal G, Koyuncuoğlu EN, Arlıer S (October 1, 2026) Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery. Journal of Health Sciences and Medicine 9 6 1887–1893.

IEEE

[1]Ş. Gül Aydın, G. Uysal, E. N. Koyuncuoğlu, and S. Arlıer, “Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery”, J Health Sci Med / JHSM, vol. 9, no. 6, pp. 1887–1893, Oct. 2026, doi: 10.32322/jhsm.2013560.

ISNAD

Gül Aydın, Şule - Uysal, Gülsüm - Koyuncuoğlu, Eda Nur - Arlıer, Sefa. “Preoperative Ultrasonographic Assessment of Vesicouterine Thickness and Its Relationship With Intra-Abdominal Adhesions at Repeat Cesarean Delivery”. Journal of Health Sciences and Medicine 9/6 (October 1, 2026): 1887-1893. https://doi.org/10.32322/jhsm.2013560.

JAMA

1.Gül Aydın Ş, Uysal G, Koyuncuoğlu EN, Arlıer S. Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery. J Health Sci Med / JHSM. 2026;9:1887–1893.

MLA

Gül Aydın, Şule, et al. “Preoperative Ultrasonographic Assessment of Vesicouterine Thickness and Its Relationship With Intra-Abdominal Adhesions at Repeat Cesarean Delivery”. Journal of Health Sciences and Medicine, vol. 9, no. 6, Oct. 2026, pp. 1887-93, doi:10.32322/jhsm.2013560.

Vancouver

1.Şule Gül Aydın, Gülsüm Uysal, Eda Nur Koyuncuoğlu, Sefa Arlıer. Preoperative ultrasonographic assessment of vesicouterine thickness and its relationship with intra-abdominal adhesions at repeat cesarean delivery. J Health Sci Med / JHSM. 2026 Oct. 1;9(6):1887-93. doi:10.32322/jhsm.2013560