Lower Placental Edge Thickness in Relation to Gestational Age at Delivery in Placenta Accreta (Prospective Cohort Study)

Launched by AIN SHAMS UNIVERSITY · Jan 31, 2024

Keywords

ClinConnect Summary

This clinical trial is investigating how the thickness of the placental edge, measured through ultrasound, relates to the timing of delivery in women diagnosed with placenta accreta. Placenta accreta occurs when the placenta attaches too deeply into the uterine wall, which can lead to complications during delivery. The goal of this study is to see if thinner placental edges can help predict the risk of having an emergency early delivery.

To participate in this trial, women must be pregnant with a single baby and between 28 and 36 weeks of gestation. They should have a confirmed diagnosis of placenta previa accreta, which means the placenta is covering the birth canal. Women with certain medical conditions, such as diabetes or high blood pressure, or those who have had previous surgeries on the cervix, are not eligible. Participants will have regular ultrasound evaluations to measure placental thickness. This study is currently welcoming new participants, and it aims to provide valuable information that could improve care for women facing this condition.

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • Single, viable gestations. Gestational age \>28 weeks, \< 36 weeks.
• Confirmed diagnosis of placenta previa accreta when the placenta lies directly over the internal os based on ultrasound features among RCOG criteria as follows) RCOG,2019):
• • 2D greyscale signs: loss of myometrial interface or retroplacental clear space, reduced myometrial thickness, intra-placental blood flow and intra-placental lacunae.
• • 2D color Doppler signs: intra-placental blood flow, the presence of altered blood flow in the retroplacental space and aberrant vessels crossing between placental surfaces.
• • First time of diagnosis of placenta previa accreta is 28-30 weeks. Previous one or more cesarean sections.
• Exclusion Criteria:
• • Maternal medical co-morbidities like diabetes and hypertension. Patients with bleeding disorders or anticoagulant therapy. Over distended uterus e.g.: multiple gestation, polyhydramnios, fetal macrosomia(\>4.5kg).
• • Fetal anomalies or fetal growth restriction. Emergency cesarean section due to fetal distress. Rupture of membranes, intra-amniotic infection and fever during admission (\>38 °C).
• • History of cervical cerclage or cervical cone biopsy.