Early vs Late Bladder Dissection During CS Hysterectomy in Patients With PAS With Bladder Invasion

Cairo University (CU)

Status: Enrolling

Conditions: Cesarean Hysterectomy; Placenta Accreta Spectrum

Treatments: Procedure: Late bladder dissection; Procedure: early bladder dissection

Study type: Interventional

Funder types: Other

Identifiers

NCT05752513

MS-345-2022

Details and patient eligibility

About

Thirty-six singleton pregnant women with PAS and bladder invasion; total anterior or anterolateral invasion, who were scheduled for cesarean hysterectomy were randomly assigned into two equal groups

• Group 1: included 18 pregnant women scheduled for classical cesarean hysterectomy for placenta accreta with or without ligation of anterior division of internal iliac artery before cesarean section.
• Group 2: included 18 pregnant women scheduled for bladder last cesarean hysterectomy with or without ligation of anterior division of internal iliac artery.

Enrollment: 36 estimated patients

Sex: Female

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Age: reproductive age.
2. Pregnant with singleton living fetus.
3. Previous one or more cesarean sections.
4. Gestational age: > 34 weeks.
5. Elective or non-emergency cesarean sections.
6. Preoperative hemoglobin more than 9.5 gm/dl.

Exclusion criteria

Women with history of any medical disorder with pregnancy eg. gestational diabetes, hypertension, or anemia.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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36 participants in 2 patient groups, including a placebo group

Group 1

Placebo Comparator group

Description:

18 pregnant women scheduled for classical cesarean hysterectomy for placenta accreta

Treatment:

Procedure: early bladder dissection

Group 2

Experimental group

Description:

18 pregnant women scheduled for bladder last cesarean hysterectomy

Treatment:

Procedure: Late bladder dissection