Observation of Strategies in Placenta Accreta Spectrum Management
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Placenta Accreta Management. Basic parameters: 18 years — 50 years · Female.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Evolving Strategies in Placenta Accreta Spectrum Management: A Ten-Year Institutional Review
Overview
• Placenta accreta spectrum (PAS) disorders represent a significant obstetric challenge, characterized by abnormal adherence of the placenta to the uterine wall, leading to potentially life-threatening hemorrhage (ACOG 2020; RCOG 2018; Jauniaux 2019) during delivery. PAS includes placenta accreta (attachment to the myometrium), increta (invasion into the myometrium), and percreta (penetration through the uterine serosa, often involving adjacent organs). The incidence of PAS is rising globally, largely attributed to the increased rates of cesarean section and uterine surgeries (Bowman 2021). Effective management of PAS is crucial to prevent severe maternal morbidity and mortality. The cornerstone of management remains surgical intervention, with cesarean hysterectomy being the traditional gold standard (Eller 2009; ACOG 2020), especially in cases of extensive invasion. However, conservative and fertility-preserving surgical techniques have emerged in recent years as viable alternatives in selected cases (Jauniaux 2019). In Assiut university hospital, diverse surgical approaches are practiced depending on the extent of placental invasion, surgeons expertise, and patient fertility desires. These include cesarean hysterectomy, segmental uterine resection, the Triple-P procedure, and uterus-preserving methods such as leaving the placenta in situ. (ijrcog) A notable contribution to conservative PAS management in Egypt is the Placental Pouch Closure technique. This technique involves careful resection of the invaded uterine wall followed by multilayered closure of the resulting myometrial defect (the "placental pouch"), thereby controlling hemorrhage while preserving uterine integrity. (Zahran et al. 2020) . • This retrospective study aims to evaluate the pattern and outcomes of various surgical approaches used in the management of placenta accreta spectrum disorders over a 10-year period at a Assiut university hospital. Special attention will be paid to the adoption, safety, and effectiveness of conservative techniques
Primary outcome measures
- Patterns of management over time [Time frame: 10 years]
Eligibility criteria
Inclusion criteria
- \- Women diagnosed with PAS (accreta, increta, percreta).
- Deliveries conducted at Women's Health Hospital.
- Age 18-50 years.
- Availability of complete medical records and operative details.
Exclusion criteria
- \- Patients with incomplete records or missing surgical reports.
- Cases managed outside the hospital.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Study design
- Observational model
- Case-control
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Eller AG, Porter TF, Soisson P, Silver RM. Optimal management strategies for placenta accreta. BJOG. 2009 Apr;116(5):648-54. doi: 10.1111/j.1471-0528.2008.02037.x. Epub 2009 Feb 4. PMID 19191778
- Jauniaux E, Ayres-de-Campos D, Langhoff-Roos J, Fox KA, Collins S; FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2019 Jul;146(1):20-24. doi: 10.1002/ijgo.12761. PMID 31173360
- Jauniaux E, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, Dornan S, Jurkovic D, Kayem G, Kingdom J, Silver R, Sentilhes L; Royal College of Obstetricians and Gynaecologists. Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green-top Guideline No. 27a. BJOG. 2019 Jan;126(1):e1-e48. doi: 10.1111/1471-0528.15306. Epub 2018 Sep 27. No abstract available. PMID 30260097
Identifiers
NCT: NCT07236710 · placenta Accreta management