The study objective is the significance of the ultrasound detection of the paracervical pouch in placenta accreta spectrum. It aimed to evaluate its relation to the degree of placenta accreta spectrum, amount of the blood loss and the number of packed red blood cells transfused.
The study will be carried on patients diagnosed with placenta previa or placenta accreta spectrum and had at least one caesarean section. The study will be divided into 2 groups of 70 patients at least per each. The first group will include patients in whom a paracervical pouch is detected, and the second group will include patients in whom the pouch is not detected by transvaginal ultrasound. paracervical pouch is defined ultrasonographic as the downward displacement of the uterine serosa from the level of the cervical internal os
Study Type
OBSERVATIONAL
Enrollment
190
Faculty of Medicine
Alexandria, Egypt
the rate of intraoperative diagnosis of placenta accreta spectrum
the number of patients diagnosed intraoperatively with placenta accreta spectrum according to international federation of obstetrics and gynecology in both groups.
Time frame: intraoperative
calculated amount of blood loss
the total amount blood lost intraoperatively in millilitres.
Time frame: intraoperative and 24 hours postoperative
blood transfusion
the amount of packed red blood cell, fresh frozen plasma and platelets transfused in both groups.
Time frame: intraoperative and 24 hours postoperative
rate of hysterectomy
the percentage of cases had hysterectomy in both groups.
Time frame: intraoperative till 40 days postoperative
internal iliac artery ligation
the rate of internal iliac artery ligation in both groups.
Time frame: intraoperative
Intensive care unit admission
the number of patients admitted to the intensive care unit and the duration of their stay.
Time frame: postoperative for 5 days
hospital stays
the duration of hospital stays after the operation.
Time frame: postoperative for 1 month
the presence of intraoperative pouch
the detection of an intraoperative paracervical pouch grossly.
Time frame: intraoperative
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total operation time
the duration from the skin incision till skin closure.
Time frame: intraoperative
repair time
the duration from the placental separation till closure of the first layer.
Time frame: intraoperative
preoperative hemoglobin levels in gm/dl
the amount of the hemoglobin measured in gm/dl before the operation in both groups.
Time frame: 24 hours before the operation
postoperative hemoglobin levels in gm/dl
the amount of the hemoglobin measured in gm/dl after the operation in both groups.
Time frame: 6 hours postoperative
rate of uterine wall disruption
the number of patients who have a disruption of their anterior uterine wall during bladder dissection or placental separation in both groups.
Time frame: intraoperative