Early vs Late Bladder Dissection During CS Hysterectomy in Patients With PAS With Bladder Invasion

Cairo University36 enrolled

Overview

Thirty-six singleton pregnant women with PAS and bladder invasion; total anterior or anterolateral invasion, who were scheduled for cesarean hysterectomy were randomly assigned into two equal groups * Group 1: included 18 pregnant women scheduled for classical cesarean hysterectomy for placenta accreta with or without ligation of anterior division of internal iliac artery before cesarean section. * Group 2: included 18 pregnant women scheduled for bladder last cesarean hysterectomy with or without ligation of anterior division of internal iliac artery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Placenta Accreta Spectrum Cesarean Hysterectomy

Interventions

The bladder dissection is reserved as the last step of the cesarean hysterectomy with excellent dissection of the ureteric course till the ureteric tunnel to reduce the incidence of inadvertent ureteric clamping during uterine vessel ligating and transection

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 45 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age: reproductive age. 2. Pregnant with singleton living fetus. 3. Previous one or more cesarean sections. 4. Gestational age: \> 34 weeks. 5. Elective or non-emergency cesarean sections. 6. Preoperative hemoglobin more than 9.5 gm/dl. Exclusion Criteria: Women with history of any medical disorder with pregnancy eg. gestational diabetes, hypertension, or anemia.