Evaluating Placental Thickness and Thickness of Uterine Muscle at Placenta Attachment in Prediction of Postpartum Blood Loss

Recruiting

• Conditions: Post Partum Hemorrhage

• Registration Number: NCT06351969
• Lead Sponsor: Benha University

Brief Summary

Aim of the Work is To determine the significance of the placental thickness and the thickness of the uterine muscle layer at placenta attachment in the prediction of postpartum hemorrhage and to evaluate both of them as as parameters for identifying high-risk patients.

Detailed Description

PPH remains the most common cause of maternal mortality all over the world

PPH is a serious complication ) is a serious complication of labor and delivery with an incidence of approximately 5-10% and a mortality rate 0.5:1%

PPH can also be a cause of long-term severe morbidity and approximately 12% of women who survive PPH will have severe anaemia A significant percentage of deaths due to PPH can be due to a lack in assessing bleeding amount. Clinically assessing bleeding through inspection underestimates the actual bleeding volume and depending on haemodynamic abnormalities may be to late as effective countermeasures are often not taken in time so identifying pregnant women at risk of PPH prior to delivery is crucial to prevent PPH .

The leading cause of PPH is thought to be uterine atony - the failure of the uterus to contract fully after delivery of the placenta. PPH resulting from uterine atony is a major preventable cause of maternal morbidity and mortality, especially in developing countries .(B-Lynch et al., 2006)

Risk factors for PPH and its main causes, including weak uterine contractions, birth canal lacerations, placental factors, and coagulation abnormalities have been relatively well studied .

However the effect of placental attachment on the thickness of the myometrium and its correlation with PPH is not well studied . By exploring the potential correlation between thinner myometrium at the placenta and a higher incidence of PPH we can reduce mortality occuring with PPH. this study highlight the significance of evaluating the impact of placental attachment on myometrial thickness and placenta thickness in the context of PPH

The study will be carried out on 150 pregnant women, who will undergo delivery at benha university hospital either by vaginal delivery or cesarean section either as elective palnned at operative list or admitted to Obstetrics ER after complete clinical evaluation and decision taken by staff member of Benha gynecology and obstetrics department.

Informed consent will be obtained from all participants prior to commencing the study.

Study Timeline

• Study Start: 2023-12-21
• Study First Submitted: 2024-03-28
• Status Verified: 2024-04
• Study First Submitted QC: 2024-04-04
• Last Update Submitted: 2024-04-04
• Study First Posted: 2024-04-08
• Last Update Posted: 2024-04-08
• Primary Completion: 2024-12
• Study Completion: 2024-12

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Female
• Target Recruitment: 150

Inclusion Criteria

• Term pregnancy (37 wk gastation and more )
• Single viable fetus

Exclusion Criteria

• Severe hematological disorders that could cause abnormal coagulation
• Placental implantation abnormalities or placental abruption
• Uterine anomalies, including congenital or acquired structural abnormalities.
• Previous history of PPH
• category 1 CS and category 2 CS
• Multiple pregnancy
• Preterm labour
• IUFD

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Evaluating Placental Thickness in cm and Thickness of Uterine Muscle in cm at Placenta Attachment in Prediction of Postpartum Blood Loss	follow up blood loss in ml intraoperative and 24 hour post operative	Evaluating Placental Thickness and Thickness of Uterine Muscle at Placenta Attachment in Prediction of Postpartum Blood Loss

Trial Locations

Locations (1)

Benha Univeristy; 🇪🇬 Banhā, Egypt