Placenta Accreta Spectrum Management: Uterine Preservation Using JSICA Technique - Retrospective Cross-Sectional Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 323
- Locations
- 2
- Primary Endpoint
- Intraoperative bleeding
Study Overview
Brief Summary
The goal of this study is to present the Jakarta Surgical Uterine Conservation (JSICA) technique and its perioperative outcomes in Placenta Accreta Spectrum patients. Participants are all patients undergoing standard hysterectomy or the Jakarta Surgical Uterine Conservation (JSICA) technique. Researchers will compare both groups to see if there are any differences in the perioperative outcomes.
Detailed Description
This study uses data from Cipto Mangunkusumo General Hospital's Placenta Accreta Case Register. This register includes all patients with a confirmed placenta accreta spectrum diagnosis. Data collected includes demographic characteristics, risk factors, surgery characteristics, and perioperative outcomes. In this study, researchers would like to evaluate the perioperative outcomes of the JSICA technique in comparison to a standard hysterectomy.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Focal accreta invasion ( < 50% anterior wall)
- •Anterior invasion
- •No parametrial or bladder invasion
- •Residual tissue or healthy myometrium min 3 cm above the OUI or cervix
- •Good uterine contraction post-repair (with or without compression sutures)
- •Hemodynamically stable
Exclusion Criteria
- Not provided
Arms & Interventions
Jakarta Surgical Uterine Conservation (JSICA) technique
Cipto Mangunkusumo General Hospital's novel uterine preservation technique based on standard procedure
Intervention: Jakarta Surgical Uterine Conservation (JSICA) Technique (Procedure)
Standard Hysterectomy
Surgery to remove the uterus
Intervention: Standard Hysterectomy (Procedure)
Outcomes
Primary Outcomes
Intraoperative bleeding
Time Frame: Perioperative
Intraoperative bleeding in this study was measured by the amount of blood loss (cc) and classified into \< 1.000 cc, 1.000-1.500 cc, and \> 1.500 cc. .
Operation duration
Time Frame: Perioperative
The operation duration was the time interval from skin incision to closure (hours) and classified into \< 3 hours and \> 3 hours.
Rate of Intraoperative complications
Time Frame: Intraoperative
Rate of intraoperative complications were identified by the documentation of injury to adjacent structures (bladder or ureter) or a need for transfusion.
Number of Patients Admitted to ICU
Time Frame: 24 hours
ICU admission was identified by the documentation of number of patients' admission to the ICU
Secondary Outcomes
- Rate of Intraoperative complications in JSICA compared to hysterectomy(Perioperative)
- Number of Patients Admitted to ICU in JSICA compared to hysterectomy(24 hours)
- Intraoperative Bleeding in JSICA compared to hysterectomy(Perioperative)
- Operation duration in JSICA compared to hysterectomy(Perioperative)
Investigators
Amanda Rumondang
Principal Investigator
Dr Cipto Mangunkusumo General Hospital