Hematological and Coagulation Markers in Predicting Placenta Accreta Spectrum in Placenta Previa

Hematological and Coagulation Markers in Predicting Placenta Accreta Spectrum in Patients With Placenta Previa

Status

Not yet recruiting

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07826247

Enrollment

130

Registered

2026-09-17

Start date

2026-10-01

Completion date

2027-11-01

Last updated

2026-09-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Placenta Accreta Spectrum, Placenta Previa

Keywords

Hematological markers, Coagulation markers, Complete blood count (CBC), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), D-dimer, Previous cesarean delivery

Brief summary

Placenta accreta spectrum (PAS) is a serious pregnancy complication where the placenta attaches too deeply into the wall of the uterus. This condition can lead to severe complications during delivery, including heavy bleeding, the need for blood transfusions, intensive care unit (ICU) admission, or the surgical removal of the uterus (hysterectomy). Currently, doctors primarily use ultrasound to detect PAS before birth, but the accuracy of ultrasound can vary depending on the equipment and the doctor's experience. The main goal of this study is to determine if routine, simple blood tests can serve as an additional tool to help doctors predict which mothers are at the highest risk of developing PAS. The study will involve pregnant women who have placenta previa (a low-lying placenta) and a history of a previous cesarean delivery. Researchers will collect a standard blood sample when the mother is admitted to the hospital to look at specific markers, including a complete blood count (CBC) and blood clotting (coagulation) factors. By comparing these admission blood test results with the actual diagnosis of PAS confirmed during delivery, researchers hope to identify a reliable way to predict this condition. Improving the early detection of PAS could help medical teams better prepare for high-risk deliveries, optimize surgical planning, and ultimately improve health outcomes for mothers.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

FEMALE

Age

18 Years to 40 Years

Inclusion criteria

* Age: 18-40 years * Placenta previa diagnosed by ultrasound * Singleton pregnancy * Gestational age \>28 weeks * Previous cesarean delivery * Hemodynamically stable on admission

Exclusion criteria

* Intrauterine fetal demise (IUFD) * Intrauterine growth restriction (IUGR) * Premature rupture of membranes (PROM) * Chorioamnionitis * Patients with known blood disease or bleeding tendency * Hypertension (HTN) * Diabetes mellitus (DM)

Design outcomes

Primary

Measure	Time frame	Description
Diagnostic Accuracy of the Systemic Immune-Inflammation Index (SII) for Predicting Placenta Accreta Spectrum	Within 12 weeks of enrollment	Evaluation of the predictive value of the maternal Systemic Immune-Inflammation Index (SII) for diagnosing placenta accreta spectrum (PAS). The SII is calculated from the complete blood count (neutrophils × platelets / lymphocytes) collected on hospital admission. Diagnostic accuracy will be quantified using the Area Under the Receiver Operating Characteristic (ROC) curve to determine the optimal cut-off point, sensitivity, and specificity. The reference standard diagnosis of PAS is confirmed via intraoperative assessment at the time of delivery.

Outcome results