Vesico-uterin Thickness and Sliding Sign in Term Pregnancies (sliding sign)

April 15, 2026 updated by: Gulsum Uysal, Adana City Training and Research Hospital

Comparision of Ultrasonographic Vesicouterin Thickness Measurement and Sliding Sign in Term Pregnancies With and Without Cesarean Surgery

In this study, our aim was to evaluate the relationship of the bladder to the uterus including vesicouterin thickness and sliding sign in term pregnancies with at least one previous cesarean section and compare to controls.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The study aimed to evaluate the bladder and uterus ultrasonographically and intraabdominal adhesions prior the cesarean section. Pregnant women aged 18-45 years with singleton, viable third-trimester (37 weeks of gestation or later) pregnancies with the history of at least one previous cesarean section were included in the study. The control group consisted of healthy pregnant women in the third trimester with similar demographic characteristics who underwent elective (planned) cesarean delivery and had no obstetric or medical comorbidities. Control group had no history of previous cesarean section. The indications in control group for cesarean section consisted cephalopelvic disproportion and rare other malpresentations.Exclusion criteria included uterine anomalies, intra-abdominal cysts or myomas, multiple pregnancies, a history of additional intra-abdominal surgery, a history of steroid use, collagen disorders, and placental adhesion or invasion anomalies. To ensure homogeneity between groups, patients with comparable body mass index values were preferentially selected.

The patients' obstetric history at the time of admission (gravida, parity, abortion), age, height, weight, gestational age, routine obstetric measurements (fetal position, placental location, amniotic fluid volume, etc.), personal and family history were all recorded. Birth weight and Apgar scores of the newborns were also recorded.

The cesarean scar incision line was visually examined and scored. The scar incision score recorded as inwardly displaced (deplaced), at skin level (flat), or raised (keloid-like).

Stretch marks that form on the abdomen during pregnancy were evaluated and noted according to the proportion they cover when the abdomen was divided into four sections. Stretch mark scores recorded as follows: none for absence of stretch marks, 1/4 for quarter, 1/2 for half and 3/4 for one-third of the abdomen.Intra-abdominal adhesions in patients undergoing cesarean section were classified according to the Nair adhesion scoring system, regardless of prior ultrasound assessment.

Accordingly, the classification recorded as follows: Grade 0: absence of adhesions, Grade 1: presence of a single band of adhesion between the visceral peritoneum and the abdominal surface, Grade 2: presence of two bands of adhesion between the visceral peritoneum and the abdominal surface, Grade 3: presence of three or more bands of adhesion between the visceral peritoneum and the abdominal surface, Grade 4: presence of multiple dense adhesions. The presence of the sliding sign was evaluated as described by Baron et al..The probe was placed just above the transverse skin scar and the patient was asked to take a deep breath or cough in order for the uterus to be observed sliding caudally under the parietal peritoneum and fascia transversalis. Presence of the sliding sign was described "positive" when sliding of the uterus against the abdominal wall was observed. When no movement of the uterus under the fascia, the sliding sign was considered "negative".

The relationship of the bladder to the uterus, whether it was below or above the symphysis pubis were noted. The tissue between the uterus and bladder (vesicouterin thickness) was examined and mesasured.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
117

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Yuregir
      • Adana, Yuregir, Turkey (Türkiye), 01230
        • University of Heath and Science Adana City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • 18-45 years
  • viable singleton third-trimester (37 weeks of gestation or later) pregnancies
  • history of at least one previous cesarean section

Exclusion Criteria:

  • uterine anomalies,
  • intra-abdominal cysts or myomas,
  • multiple pregnancies,
  • history of additional intra-abdominal surgery,
  • history of steroid use, collagen disorders,
  • placental adhesion or invasion anomalies.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: intervention (study) group
repeated cesarean group
Other: ultrasound evaluation
The probe was placed just above the transverse skin scar and the patient was asked to take a deep breath or cough in order for the uterus to be observed sliding caudally under the parietal peritoneum and fascia transversalis. Presence of the sliding sign was described "positive" when sliding of the uterus against the abdominal wall was observed. When no movement of the uterus under the fascia, the sliding sign was considered "negative".
Other Names:
  • Sliding sign
  • vesico-uterin thickness
Active Comparator: control group
primigravid patients
Other: ultrasound evaluation
The probe was placed just above the transverse skin scar and the patient was asked to take a deep breath or cough in order for the uterus to be observed sliding caudally under the parietal peritoneum and fascia transversalis. Presence of the sliding sign was described "positive" when sliding of the uterus against the abdominal wall was observed. When no movement of the uterus under the fascia, the sliding sign was considered "negative".
Other Names:
  • Sliding sign
  • vesico-uterin thickness

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
sliding sign
Time Frame: The study will end when a sufficient number of patients is reached.
The probe was placed just above the transverse skin scar and the patient was asked to take a deep breath or cough in order for the uterus to be observed sliding caudally under the parietal peritoneum and fascia transversalis. Presence of the sliding sign was described "positive" when sliding of the uterus against the abdominal wall was observed. When no movement of the uterus under the fascia, the sliding sign was considered "negative".
The study will end when a sufficient number of patients is reached.
Vesicouterin thickness
Time Frame: Approximately 6 months. The study will complete when required number of patients reached.
The tissue between the uterus and bladder (vesicouterin thickness) was examined and mesasured.
Approximately 6 months. The study will complete when required number of patients reached.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Adana City Training and Research Hospital

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Gülsüm Uysal, Department of Obstetrics and Gynecology, University of Health and Science Adana City Training and Research Hospital, Adana, Turkey

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 1, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 30, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 30, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 6, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 6, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 13, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 21, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 15, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 3015/12.2023

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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