Placenta Accreta
Conditions
Keywords
placenta adherence
Brief summary
The study objective is the significance of the ultrasound detection of the paracervical pouch in placenta accreta spectrum. It aimed to evaluate its relation to the degree of placenta accreta spectrum, amount of the blood loss and the number of packed red blood cells transfused.
Detailed description
The study will be carried on patients diagnosed with placenta previa or placenta accreta spectrum and had at least one caesarean section. The study will be divided into 2 groups of 70 patients at least per each. The first group will include patients in whom a paracervical pouch is detected, and the second group will include patients in whom the pouch is not detected by transvaginal ultrasound. paracervical pouch is defined ultrasonographic as the downward displacement of the uterine serosa from the level of the cervical internal os
Interventions
None listed
Sponsors
Alexandria University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
19 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* • Patients between 19 to 40 years old * Patients had at least one cesarean section.
Exclusion criteria
* • Patients who request hysterectomy. * Patients diagnosed with hepatitis B, C, or HIV, * Those with bleeding diathesis. * Patients whose BMI is more than 40 kg/m2. * Patients who need an emergency cesarean section.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the presence of intraoperative pouch | intraoperative | the detection of an intraoperative paracervical pouch grossly. |
| calculated amount of blood loss | intraoperative and 24 hours postoperative | the total amount blood lost intraoperatively in millilitres. |
| blood transfusion | intraoperative and 24 hours postoperative | the amount of packed red blood cell, fresh frozen plasma and platelets transfused in both groups. |
| rate of hysterectomy | intraoperative till 40 days postoperative | the percentage of cases had hysterectomy in both groups. |
| Intensive care unit admission | postoperative for 5 days | the number of patients admitted to the intensive care unit and the duration of their stay. |
| hospital stays | postoperative for 1 month | the duration of hospital stays after the operation. |
| internal iliac artery ligation | intraoperative | the rate of internal iliac artery ligation in both groups. |
| the rate of intraoperative diagnosis of placenta accreta spectrum | intraoperative | the number of patients diagnosed intraoperatively with placenta accreta spectrum according to international federation of obstetrics and gynecology in both groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| repair time | intraoperative | the duration from the placental separation till closure of the first layer. |
| preoperative hemoglobin levels in gm/dl | 24 hours before the operation | the amount of the hemoglobin measured in gm/dl before the operation in both groups. |
| postoperative hemoglobin levels in gm/dl | 6 hours postoperative | the amount of the hemoglobin measured in gm/dl after the operation in both groups. |
| rate of uterine wall disruption | intraoperative | the number of patients who have a disruption of their anterior uterine wall during bladder dissection or placental separation in both groups. |
| total operation time | intraoperative | the duration from the skin incision till skin closure. |
Countries
Egypt
Outcome results
None listed