Effectivness of Conservative Techniques in Management of PAS

NCT05104177 | Unknown

• 1 other identifier: conservative techniques in PAS
• Study Type: observational
• Target: 80
• Locations: 0 countries
• Sites: N/A

Brief Summary

To evaluate the effectiveness of conservative techniques for placenta accreta spectrum to reduce maternal mortality and morbidity

Conditions

Placenta Accreta

Outcome Measures

Primary Outcomes (1)

• number of patients who undergo hysterectomy after failure of conservative techniques

  Counting patients who undergo hystrectomy after conservative techniques to evalute it's effectivness

  baseline

Secondary Outcomes (1)

• recurrence of PAS

  baseine

Interventions

conservative tecchniques in management of PAS PROCEDURE

Meticulous complete dissection of the urinary bladder from the lower uterine segment. * Transverse uterine incision above the visible vascular bulge if visible in cases with anterior PAS, otherwise a transverse lower uterine segment incision is performed in the same site of previous CS scar. * Delivery of the baby, clamping of the cord and administration IV 10 IU oxytocin. * Bilateral uterine artery ligation at one or two levels below the lowermost part of the placenta. * Removal of the separable part of the placenta from above downwards, until the adherent part is encountered. * A decision is taken to either resect a wedge of the myometrium above the adherent placenta (in case the adherent area is small and anterior), or removing all the adherent placenta then inserting a rubber or plastic catheter inside the cervical canal then identifying and closing the placental pouch. Care is given to rapidly perform this step to decrease the blood loss after removing the placenta

Eligibility Criteria

• Age: 19 Years - 50 Years
• Gender Eligibility Details: females in reproductive age
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

females in reproductive age

You may qualify if:

• \- Gestational age starting from 28 weeks onwards.
• \- Women with at least 1 previous hysterotomy (e.g. Caesarean deliveries, myomectomy)
• \- Elective or emergent Caesarean deliveries

You may not qualify if:

• A pre-existing decision of performing intrapartum hysterectomy

Sponsors & Collaborators

• Assiut University: lead

Related Publications (1)

• Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am J Obstet Gynecol. 2018 Jan;218(1):75-87. doi: 10.1016/j.ajog.2017.05.067. Epub 2017 Jun 24.

  PMID: 28599899 BACKGROUND

MeSH Terms

Conditions

Placenta Accreta

Condition Hierarchy (Ancestors)

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

Central Study Contacts

mohammed heshmat

CONTACT

01030752354; heshmatm905@gmail.com

Alaa El-Din Ismail

CONTACT

01063224000; prof.alaaismail@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 10 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: October 9, 2021
• First Posted: November 2, 2021
• Study Start: November 1, 2021
• Primary Completion: November 1, 2022
• Study Completion: December 1, 2022
• Last Updated: November 9, 2021

Record last verified: 2021-11