Placenta Accreta
Conditions
Brief summary
Background: An optimal international standard for PAS surgery is not yet available, and the establishment of a suitable surgical method is an important focus of in PAS management. Objective: To assess the efficacy and safety of tourniquet uses for conservative approach in the management of placenta accerta spectrum. Patients and Methods: 40 pregnant women who underwent conservative management of placenta accrete at Kasr El-Aini hospital (Obstetrics and gynecology department - Faculty of medicine - Cairo university) were included and were divided according to the use of tourniquet into 2 equal groups: Study group (tourniquet group): consists of 20 women for whom tourniquet was used in the lower part of the uterus during surgical treatment of placenta accreta spectrum.Control group (no tourniquet group): consists of 20 women for whom no tourniquet was used.
Interventions
PROCEDUREUterovesical tourniquet before uterine devascularization steps
Insertion of a Foley catheter tourniquet through broad ligament apertures & tightening it immediately before hysterotomy in cases of conservative management of placenta accreta spectrum
PROCEDUREConventional conservative surgery
Conventional conservative surgery
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Pregnant females with previous CS deliveries (at least 1). * Patients with ultrasound criteria of placenta accerta spectrum. * Patients desiring fertility (uterine conservation). * Patients with gestational age that completed 34 weeks (or more) confirmed by the 1st day of the LMP or 1st trimester ultrasound scan.
Exclusion criteria
* Maternal age above 40 years. * Chronic medical disorders (e.g., cardiac, renal, DM and hepatic diseases). * Patients presented with severe antepartum hemorrhage (unstable vital signs). * Patients requested radical management (caesarean hysterectomy).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative quantified blood loss | during operation | Quantified blood loss estimate with the tourniquet |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| amount of blood and blood product transfusion | during operation and 48 hours post operative | amount of blood and blood product transfusion |
Countries
Egypt
Outcome results
None listed