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

September 13, 2026 updated by: Mariam Khalifa Abdelnour Dous, Assiut University

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

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.

Study Overview

Status

Not yet recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

130

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

The study population consists of pregnant women aged 18 to 40 years presenting to the Women's Health Hospital at Assiut University. Eligible participants must have a singleton pregnancy at a gestational age greater than 28 weeks, a diagnosis of placenta previa confirmed by ultrasound, a history of previous cesarean delivery, and be hemodynamically stable upon admission. Patients will be excluded if they present with intrauterine fetal demise (IUFD), intrauterine growth restriction (IUGR), premature rupture of membranes (PROM), chorioamnionitis, known blood diseases or bleeding tendencies, hypertension, or diabetes mellitus.

Description

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)

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

Cohorts and Interventions

Group / Cohort
Patients with Placenta Previa and Previous Cesarean Delivery
This cohort consists of pregnant women aged 18 to 40 years with a singleton pregnancy at >28 weeks gestational age. Participants must be diagnosed with placenta previa via ultrasound, have a history of previous cesarean delivery, and be hemodynamically stable on admission. Participants will undergo an antenatal ultrasound to assess for signs of placenta accreta spectrum (PAS). Venous blood samples will be collected upon admission to evaluate complete blood count (CBC) parameters (including calculation of inflammatory indices like NLR, PLR, SII, and SIRI) and a coagulation profile (PT, PC, INR, aPTT, and D-dimer).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diagnostic Accuracy of the Systemic Immune-Inflammation Index (SII) for Predicting Placenta Accreta Spectrum
Time Frame: 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.
Within 12 weeks of enrollment

Collaborators and Investigators

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

Sponsor

Assiut University

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)

October 1, 2026

Primary Completion (Estimated)

October 1, 2027

Study Completion (Estimated)

November 1, 2027

Study Registration Dates

First Submitted

September 13, 2026

First Submitted That Met QC Criteria

September 13, 2026

First Posted (Actual)

September 17, 2026

Study Record Updates

Last Update Posted (Actual)

September 17, 2026

Last Update Submitted That Met QC Criteria

September 13, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Markers for PAS in Previa

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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