Observation of Strategies in Placenta Accreta Spectrum Management

November 15, 2025 updated by: Mohamed Ayman Saad zaghlol Abdallah, Assiut University

Evolving Strategies in Placenta Accreta Spectrum Management: A Ten-Year Institutional Review

• 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

Study Overview

Status

Not yet recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

300

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

All pregnant women diagnosed with placenta accreta spectrum disorders during the study period

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patterns of management over time
Time Frame: 10 years
Patterns of management of placenta Accreta in retrospective way on the last 10 years
10 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 20, 2025

Primary Completion (Estimated)

October 20, 2027

Study Completion (Estimated)

December 30, 2027

Study Registration Dates

First Submitted

November 15, 2025

First Submitted That Met QC Criteria

November 15, 2025

First Posted (Actual)

November 19, 2025

Study Record Updates

Last Update Posted (Actual)

November 19, 2025

Last Update Submitted That Met QC Criteria

November 15, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • placenta Accreta management

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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