Long-term Follow up of the Cases Who Underwent Conservative Surgery for Placenta Previa Accreta: a Prospective Case Series Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Placenta Accreta
- Sponsor
- Ain Shams Maternity Hospital
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Menstrual pattern
- Status
- Completed
- Last Updated
- 2 years ago
Overview
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.
Investigators
Mahmoud Mohamed Ghaleb
Professor
Ain Shams Maternity Hospital
Eligibility Criteria
Inclusion Criteria
- •Pregnant women with one or more previous cesarean deliveries
- •Women diagnosed with placenta previa accreta and underwent Conservative stepwise surgical approach for management.
Exclusion Criteria
- •women who refused to participate in the study.
- •Associated other medical conditions as pregnancy-induced hypertension, heart diseases, and rheumatological diseases apart from iron deficiency anemia.
- •Presence of uterine anomalies
Outcomes
Primary Outcomes
Menstrual pattern
Time Frame: 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
Time Frame: 3-6 months
accessibility of hysteroscopic examination
cesarean scar niche
Time Frame: 3-6 months
presence of a pouch, that forms on the wall of your uterus.
Adequacy of uterine cavity
Time Frame: 3-6 months
visualization of the uterus will be assessed using office hysteroscopy
intrauterine adhesions
Time Frame: 3-6 months
visualization of the intrauterine adhesions will be assessed using office hysteroscopy