Placenta Accreta Spectrum
Conditions
Brief summary
This study evaluates whether adding Hayman sutures in the conservative Management of Placenta Accreta Spectrum Using Kasr Al-Ainy Technique reduces intraoperative blood loss and improves outcomes
Interventions
PROCEDUREKasr Al-Ainy Technique Alone
1. Vascular Ligation: Bilateral uterine artery tying at high and low levels. 2. Compression Sutures: Anterior and posterior cervicovaginal stitches for hemostasis. 3. Segmental Resection: Excision of invaded myometrium and placental tissue. 4. Dual-Layer Repair: Myometrial approximation followed by reinforcing imbricating sutures. 5. Final Hemostasis: Confirmation of bleeding control prior to abdominal closure.
PROCEDUREKasr Al-Ainy Technique + Hayman Sutures
1. Vascular Ligation: Bilateral uterine artery tying at high and low levels. 2. Compression Sutures: Anterior and posterior cervicovaginal stitches for hemostasis. 3. Segmental Resection: Excision of invaded myometrium and placental tissue. 4. Dual-Layer Repair: Myometrial approximation followed by reinforcing imbricating sutures. 5. Final Hemostasis: Confirmation of bleeding control prior to abdominal closure. 6. Application of Hayman vertical compression sutures
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-40 years * Antenatal PAS diagnosis confirmed by TAS/TVS/Doppler * Eligible for conservative Kasr Al-Ainy surgery * Singleton pregnancy * Written informed consent
Exclusion criteria
* Multiple pregnancy * Uterine fibroids * Previous cesarean myomectomy * Cervical accreta * Extensive parametrial or bladder invasion requiring hysterectomy * Known coagulopathy or uncorrected bleeding disorder. * Severe medical comorbidities rendering the patient unfit for major surgery under general anesthesia (e.g., severe cardiac or pulmonary disease) * Medical disorders as HTN and DM * Patient refusal
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Intra-operative estimated blood loss | During operation |
Contacts
CONTACTAbdallah Mousa, M.D.
CONTACTAsmaa Ali
PRINCIPAL_INVESTIGATOREmad Salah, M.D.
Cairo University
PRINCIPAL_INVESTIGATORMona Sedik, M.D.
Cairo University
Outcome results
None listed