New Conservative Technique for Placenta Accreta Spectrum
NCT ID: NCT04427592
Last Updated: 2023-12-06
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
159 participants
INTERVENTIONAL
2020-07-28
2023-05-20
Brief Summary
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Investigators manually detected a plan of cleavage through which the placenta was separated followed by closure of defective placental bed.
Data were collected about the outcome.
Detailed Description
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Cesarean section will be performed through extended transverse supra-pubic incision bladder dissection from anterior uterine wall using electro-coagulation instruments and double ligation of large caliber bridging vessels.
Uterine incision above the placental bulge by at least 5 mm then complete separation of the placenta starting from least resistance plans to high resistant one leaving a clear defect which will be closed by running sutures from inside the uterus and controlling placental bed hemorrhage then closing the uterine incision with compressing the bed from outwards ( double compression sutures ) internal Iliac artery ligation may be done as a complementary measure to control the bleeding from abnormal pelvic vasculature, insertion of intraperitoneal drain and closure of abdominal wall in layers.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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pregnant women with placenta accreta spectrum
The participants were subjected to ultrasound to diagnose placenta accreta spectrum followed by new conservative surgical technique.
ultrasound
trans-vaginal and trans-abdominal ultrasound using different modalities such as grey-scale, Doppler, multi-planer mode
closure of uterine wall defect
uterine incision above placental bulge by at least 5 mm then complete separation of the placenta starting from areas of least resistance to areas of high resistance leaving a clear defect which will be closed by non locked running sutures from inside the uterus starting from one edge, hitch the bed to the other edge of the defect and controlling placental bed hemorrhage then closing the uterine incision via running sutures in 2 layers with compressing the bed from outwards in the first layer. hemostasis of the abnormal pelvic vasculature if excessive bleeding internal iliac artery may be ligated then insertion of intra-peritoneal drain followed by closing the abdomen.
Interventions
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ultrasound
trans-vaginal and trans-abdominal ultrasound using different modalities such as grey-scale, Doppler, multi-planer mode
closure of uterine wall defect
uterine incision above placental bulge by at least 5 mm then complete separation of the placenta starting from areas of least resistance to areas of high resistance leaving a clear defect which will be closed by non locked running sutures from inside the uterus starting from one edge, hitch the bed to the other edge of the defect and controlling placental bed hemorrhage then closing the uterine incision via running sutures in 2 layers with compressing the bed from outwards in the first layer. hemostasis of the abnormal pelvic vasculature if excessive bleeding internal iliac artery may be ligated then insertion of intra-peritoneal drain followed by closing the abdomen.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
pregnant women had 5 or more previous Cesarean sections or their age more than 40 years
19 Years
40 Years
FEMALE
No
Sponsors
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Alexandria University
OTHER
Responsible Party
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Mahmoud A Hamdy
principal investigator
Principal Investigators
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Mahmoud AH Hamdy, A. lecturer
Role: PRINCIPAL_INVESTIGATOR
faculty of medicine department of obstetrics and gyneacology
Locations
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Faculty of Medicine
Alexandria, , Egypt
Countries
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References
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Sentilhes L, Kayem G, Chandraharan E, Palacios-Jaraquemada J, Jauniaux E; FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management. Int J Gynaecol Obstet. 2018 Mar;140(3):291-298. doi: 10.1002/ijgo.12410. No abstract available.
Other Identifiers
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H.R501
Identifier Type: -
Identifier Source: org_study_id