A Comparison Between Bladder Dissection Before and After Uterine Incision During Cesarean Section for Placenta Accreta Spectrum: A Randomized Controlled Study

Launched by AIN SHAMS UNIVERSITY · Apr 26, 2025

Keywords

ClinConnect Summary

This clinical trial is studying the best way to manage bladder dissection during cesarean sections for women with placenta accreta, a condition where the placenta attaches too deeply into the uterine wall. The trial aims to compare whether it's safer to perform bladder dissection before or after making the uterine incision during the surgery. This is important because placenta accreta can lead to serious complications for both mothers and babies, especially during surgery.

Women who may be eligible to participate in this trial are those who have had at least two previous cesarean sections, have a body mass index (BMI) of 35 or less, are at least 32 weeks pregnant with a viable baby, and have any degree of placenta previa (where the placenta covers the cervix). Participants will need to be willing to provide informed consent and must not have a history of bladder injuries or certain medical conditions. The trial is not yet recruiting, but it represents an important step in improving surgical techniques and outcomes for women facing this challenging condition.

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • Women with BMI at or under 35kg/m2
• • Women with history of at least previous two caesarean section
• • Gestational age more than 32 weeks with viable fetus.
• • Women with any degree of placenta previa.
• • Women with placenta falling in the PAS.
• • Willing and able to provide informed consent.
• Exclusion Criteria:
• • o History of urinary bladder injury.
• • History of urinary or renal disorders
• • Women with coagulation disorders or on anticoagulation therapy.
• • Patients who are hemodynamically unstable before skin incision