None listed
Conditions
Brief summary
20 women with adherent placenta presenting during an emergency will be compared to 20 women with adherent placenta presenting electively. Both groups will be compared regarding their base line criteria, their sonographic and Doppler findings, the operation time, whether the CS was upper segment or lower segment and if removal of the placenta was attempted
Interventions
20 women with placenta accreta presenting to the labour ward in an emergency (Group1) will be compared to 20 women having elective Cesarean section (CS) for placenta accreta (Group2).
Both groups will be compared regarding their base line criteria, their sonographic and Doppler findings, the management, operation time, whether the CS was upper segment or lower segment and if removal of the placenta was attempted.
Each participant is expected to be observed 4 times during the study and the overal
20 women with placenta accreta presenting to the labour ward in an emergency (Group1) will be compared to 20 women having elective Cesarean section (CS) for placenta accreta (Group2). Both groups will be compared regarding their base line criteria, their sonographic and Doppler findings, the management, operation time, whether the CS was upper segment or lower segment and if removal of the placenta was attempted. Each participant is expected to be observed 4 times during the study and the overall duration of observation is expected to be one week. All women will be subjected to full history taking, abdominal examination, ultrasound examination to confirm fetal number, viability, gestational age, exclusion of congenital anomalies and assessment of the amniotic fluid index and localization of the placenta All women with Placenta previa and women with previous CS who have anterior placentas covering the CS scar are at increased risk of having placenta accreta. Placenta accreta will be suspected using a grey scale ultrasound when there is loss of the retroplacental sonolucent zone, irregular retroplacental sonolucent zone, thinning or disruption of the hyperechoic serosa–bladder interface, presence of focal exophytic masses invading the urinary bladder or the presence of abnormal placental lacunae. In the presence of any of the previous criteria colour Doppler will be applied and the following criteria will support the diagnosis of placenta accreta: diffuse or focal lacunar flow, vascular lakes with turbulent flow (peak systolic velocity over 15 cm/s), hypervascularity of serosa–bladder interface, or markedly dilated vessels over peripheral subplacental zone. 3D ultrasound and MRI facilities are not available in the labour ward, but women presenting electively can have 3D ultrasound, MRI scan or both if necessary for further confirmation of placenta accreta. placenta accreta will be confirmed clinically and histopathologically. Women presenting to the labour ward will have a CS if they have regular uterine contractions, excessive bleeding indicating delivery or if their gestational age is greater than or equal to 38 weeks. All women will have CS and placenta accreta will be confirmed clinically and histopathologically.
Sponsors
Cairo University
Eligibility
Sex/Gender
All
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
-Suspected placenta accreta (In the labour ward placenta accrete will be suspected by the grey scale ultrasound and colour Doppler. In women presenting electively, 3D ultrasound or MRI may be used for further confirmation) -consent to participate in the study
Exclusion criteria
-Intra uterine fetal death. -Preeclampsia, Diabetes Mellitus or other medical disorders. - Boby mass index (BMI)>35 -Known coagulation defects
Outcome results
None listed