Conservative Surgery for Placenta Accreta

Ain Shams University

Status: Completed

Conditions: Placenta Accreta

Treatments: Procedure: conservative surgery for uterus in placenta accreta

Study type: Interventional

Funder types: Other

Identifiers

NCT04981483

11784

Details and patient eligibility

About

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

Full description

a stepwise surgical approach for conservative management of placenta previa accreta to preserve women's uterus and to evaluate the efficacy and safety of this approach in controlling postpartum hemorrhage including intrapartum hemorrhage associated with conservative management.

Enrollment: 62 patients

Sex: Female

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 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

Exclusion criteria

• women with medical disorder
• women with bleeding tendency

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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62 participants in 1 patient group

Any age and parity with placenta accreta spectrum

Experimental group

Description:

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

Treatment:

Procedure: conservative surgery for uterus in placenta accreta