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Role of peripheral inflammatory biomarkers, transforming growth factor-beta and interleukin 6 in predicting peritoneal adhesions following repeat cesarean delivery

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Abstract

Background

Repeat cesarean deliveries (CDs) pose a risk in the development of intra-abdominal adhesions.

Aim

We aimed to examine the incidence and severity of adhesions in repeat CDs using a specific scoring system and assess the predictive power of the pre-operative value of transforming growth factor (TGF)-β and interleukin (IL)-6 with selected peripheral inflammatory biomarkers (PIBs) in the prediction of adhesion formation.

Methods

This prospective study enrolled 91 pregnant women at term, who had previously undergone at least one or more scheduled CDs. PIBs, namely C-reactive protein, white blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index, TGF-β, and IL-6 were studied according to the presence and location of adhesions.

Results

There was a significant difference only in the variables of the number of CDs, post-operative adhesion index (PAI) score, IL-6, and TGF-β on the presence of adhesion (p < 0.05). The linear regression model revealed that the effect of the number of CDs, PAI score, and IL-6 values on TGF-β was significant (p < 0.05). The effect of the PAI score on TGF-β was higher than that of IL-6. As a reciprocal relationship, the effect of the TGF-β value on the PAI score was also higher than that of IL-6.

Conclusion

In patients with a history of repeat CDs, the preoperative determination of TGF-β seems to be an important independent predictor of POA. The adverse events due to post-operative adhesion caused by repeat CDs can be overcome by detecting high-risk patients with a comprehensive assessment and individualized intervention integrated into overall patient management.

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Data availability

Raw data were generated at Medipol University Medical Faculty Obstetrics and Gynecology Department. Derived data supporting the findings of this study are available from the corresponding author [P. Basim] on request.

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Author notes

  1. Elif Ciler Eren and Pelin Basım contributed equally to this manuscript

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Medipol University Medical Faculty, Istanbul, Turkey

    Elif Ciler Eren

  2. Department of General Surgery, Medipol University Medical Faculty, Istanbul, Turkey

    Pelin Basım

Authors
  1. Elif Ciler Eren
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  2. Pelin Basım
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Contributions

Concept — P.B.; design — E.C.E.; supervision — P.B.; resources — P.B., E.C.E; data collection and/or processing — E.C.E.; analysis and/or interpretation — E.C.E., P.B.; literature search — P.B; writing manuscript — E.C.E, P.B.; critical review — P.B.

Corresponding author

Correspondence to Pelin Basım.

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The ethics committee of Medipol University approved the study (date:25.06.2020; 10840098–604.01.01-E.17834 IRB number: 506).

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The authors declare no competing interests.

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Eren, E.C., Basım, P. Role of peripheral inflammatory biomarkers, transforming growth factor-beta and interleukin 6 in predicting peritoneal adhesions following repeat cesarean delivery. Ir J Med Sci 191, 2697–2704 (2022). https://doi.org/10.1007/s11845-021-02878-8

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  • DOI: https://doi.org/10.1007/s11845-021-02878-8

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