Conservative Surgery for Placenta Accreta

NCT04981483 | Completed

• 1 other identifier: 11784
• Study Type: interventional
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

A stepwise surgical approach for conservative management of placenta previa accreta.

Conditions

Placenta Accreta

Outcome Measures

Primary Outcomes (1)

• incidence rate of conserving woman's uterus

  success rate of conservative surgery for placenta accreta

  intraoperative

Secondary Outcomes (3)

• number of units of packed red blood cells , Fresh Frozen Plasma transfused ,postoperative haemoglobin

  till 48 hours postpartum

• incidence rate of cesarean hysterectomy needed

  intraoperative and 48 hours postpartum

• incidence of puerperal sepsis

  till 6 weeks postpartum

Study Arms (1)

Any age and parity with placenta accreta spectrum

EXPERIMENTAL

After removal of the placenta, grasping the cervix from the both lips and one from each side of the cervical canal at the level of the internal os, each uterine angle and grasped the remaining lower uterine segment and Nelaton catheter was inserted inside the cervical canal to avoid closing the cervix with sutures of the uterine incision.Closing the uterine incision;taking suture at the lateral angle of the cervix and suturing it to the lower edge of the uterine angle, then another continuous suture was attached to the upper edge of the uterine incision angle\[outside in-in out then out in-in out\] and the same technique was repeated on the other side (cervico-isthmic sutures). controlling bleeding from the inner surface of the remaining lower uterine segment was done by 2-3 interrupted sutures between the lower uterine segment and the anterior cervical lip. closing of the uterine incision in continuous non-locking manner

Procedure: conservative surgery for uterus in placenta accreta

Interventions

conservative surgery for uterus in placenta accreta PROCEDURE

After removal of the placenta, grasping the cervix from the both lips and one from each side of the cervical canal at the level of the internal os, each uterine angle and grasped the remaining lower uterine segment and Nelaton catheter was inserted inside the cervical canal to avoid closing the cervix with sutures of the uterine incision.Closing the uterine incision;taking suture at the lateral angle of the cervix and suturing it to the lower edge of the uterine angle, then another continuous suture was attached to the upper edge of the uterine incision angle\[outside in-in out then out in-in out\] and the same technique was repeated on the other side (cervico-isthmic sutures). controlling bleeding from the inner surface of the remaining lower uterine segment was done by 2-3 interrupted sutures between the lower uterine segment and the anterior cervical lip. closing of the uterine incision in continuous non-locking manner

Any age and parity with placenta accreta spectrum

Eligibility Criteria

• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Any age.
• Any parity.
• Previous one or more cesarean delivery.
• Placenta previa accreta diagnosis confirmed by gray scale \& color flow Doppler ultrasound in 3rd trimester. All participants had undergone abdominal ultrasound showing placenta previa anterior completely covering the internal os, with criteria suggestive of invasion by U/S

You may not qualify if:

• women with medical disorder
• women with bleeding tendency

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain SHams Maternity Hospital

Cairo, Abbaseya, Egypt

Location

MeSH Terms

Conditions

Placenta Accreta

Condition Hierarchy (Ancestors)

Obstetric Labor Complications; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Placenta Diseases

Study Officials

• mahmoud ghaleb, lecturer

  ainshams university faculty of medicine

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assisstant professor of obstetrics and gynaecology

Study Record Dates

• First Submitted: July 6, 2021
• First Posted: July 29, 2021
• Study Start: January 1, 2018
• Primary Completion: April 15, 2019
• Study Completion: June 30, 2019
• Last Updated: December 29, 2023

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)