Hysteroscopic Follow-up Following Conservative Stepwise Surgical Approach for Management of Placenta Previa Accreta

Completed

• Conditions: Placenta Accreta

• Registration Number: NCT06029985
• Lead Sponsor: Ain Shams Maternity Hospital

Brief Summary

Conservative management of placenta accreta spectrum can preserve future fertility but should only be done in hospitals with enough experience as it carries a high risk of maternal complications.

Follow up after conservative management is crucial to detect complications early.

Detailed Description

Placenta accreta is defined histopathologically as abnormal trophoblast invasion of part or all of the placenta into the myometrium of the uterine wall.1 Depending on the depth of villous tissue invasiveness, placenta accreta was subdivided by pathologists into "creta", "increta", and "percreta", in which the villi adhere superficially to the myometrium without interposing decidua, penetrate deeply into the uterine myometrium, and perforate through the entire uterine wall and may invade the surrounding pelvic organs, respectively.

The term placenta accreta spectrum (PAS) will be used in this manuscript to include both the abnormally adherent and the invasive forms of accreta placentation. Severe and sometimes life-threatening hemorrhage, which often requires blood transfusion, increases maternal morbidity and mortality.

Study Timeline

• Study Start: 2020-06-01
• Primary Completion: 2020-12-01
• Study Completion: 2020-12-31
• Study First Submitted: 2023-08-26
• Study First Submitted QC: 2023-09-01
• Study First Posted: 2023-09-08
• Status Verified: 2024-01
• Last Update Submitted: 2024-01-08
• Last Update Posted: 2024-01-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 50

Inclusion Criteria

1. Pregnant women with one or more previous cesarean deliveries
2. Women diagnosed with placenta previa accreta and underwent Conservative stepwise surgical approach for management.

Exclusion Criteria

1. women who refused to participate in the study.
2. Associated other medical conditions as pregnancy-induced hypertension, heart diseases, and rheumatological diseases apart from iron deficiency anemia.
3. Presence of uterine anomalies

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Menstrual pattern	3-6 months	menstrual irregularities by history regarding Regular and normal volume or Regular and scanty or presence of Intermenstrual bleeding
Easiness of hysteroscopy introduction	3-6 months	accessibility of hysteroscopic examination
cesarean scar niche	3-6 months	presence of a pouch, that forms on the wall of your uterus.
Adequacy of uterine cavity	3-6 months	visualization of the uterus will be assessed using office hysteroscopy
intrauterine adhesions	3-6 months	visualization of the intrauterine adhesions will be assessed using office hysteroscopy

Trial Locations

Locations (1)

Ain Shams University Maternity Hospital; 🇪🇬 Cairo, Egypt