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Conservative Management of Placenta Accreta Spectrum

NCT06253832 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 36

Last updated 2024-09-19

No results posted yet for this study

Summary

The resective-constructive surgery, detailed in prior research by Palacios-Jaraquemada JM, involves excising the placenta and its attachment on the myometrium, with modifications including the systematic use of a double JJ probe, omitting arterial ligation, and prioritizing careful dissection and reconstruction.

A prospective single-center study conducted from January 4, 2020 to February 2, 2024, at the Tunisian maternity ward including cases of placenta accreta, increta and percreta. Data on the estimation of blood loss, complications, transfusions and intensive care admissions were recorded. Diagnosis of placenta accreta was based on imaging and histopathology. The blood loss calculation incorporates total blood volume and changes in hematocrit.

Conditions

  • Placenta Accreta
  • Post Partum Hemorrhage
  • Blood Loss Massive

Interventions

PROCEDURE

conservative surgery for placenta accreta spectrum

The surgical procedure involved a midline incision for the laparotomy approach. Dissection of the uterus from the posterior bladder wall extended down to the cervix, with coagulation of the vesicouterine vessels. Hysterotomy was executed in the upper segment, just above the area of myometrial invasion. Hemostasis of the lower uterus was achieved through either square compression sutures or ligation of the colpouterine vessels. A conservative approach to uterine surgery was considered viable only under conditions of stable hemodynamics and when at least 2 cm of healthy myometrium was visibly intact above the cervix. For cases involving conservative resection, all myometrium affected by invasion and the entire placenta were excised. Subsequently, the uterus was reconstructed using a continuous stitching technique.

PROCEDURE

hysterectomy

hysterectomy for placenta accreta spectrum

PROCEDURE

hysterectomy

hysterectomy for placenta accreta spectrum

Sponsors & Collaborators

  • University Tunis El Manar

    collaborator OTHER

  • Tunis University

    lead OTHER

Principal Investigators

  • Ben Marzouk Maghrebi, Professor · Tunis University Manar

Study Design

Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
18 Years
Sex
FEMALE
Healthy Volunteers
No

Timeline & Regulatory

Start
2020-01-04
Primary Completion
2022-08-17
Completion
2024-01-30

Countries

  • Tunisia

More Related Trials

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06253832 on ClinicalTrials.gov