Placenta Accreta Clinical Trial
Official title:
Tranexamic Acid in Adherent Placenta (TAP), a Randomized Clinical Trial
The objective of this study is to investigate the effect of tranexamic acid (TXA) administration on the outcome of cesarean-hysterectomy in women with suspected Morbidly Adherent Placenta (MAP; placenta accreta, increta, percreta).
This trial is a randomized, double blind, placebo controlled trial to quantify the effects of
the preoperative administration of tranexamic acid on estimated blood loss and blood product
utilization in women undergoing cesarean-hysterectomy for suspected MAP. Subgroup analyses
will be performed for laboratory results (coagulation studies, electrolytes, complete blood
count), urine output, hemodynamic parameters, return to OR for continued bleeding,
post-operative complications (thromboembolism, wound separation, infection, fever), and
length of hospital stay. Eligible patients will be randomized to receive either TXA or
placebo.
Women eligible for inclusion will be identified during their prenatal course or on admission
to the hospital prior to surgery. They will be offered participation in the study after
appropriate counseling regarding the equipoise regarding TXA and its use in pregnancy, and
following a question and answer period they will be consented, and assigned a study number.
A randomization table will be generated by the Texas Children's Hospital Investigational
Pharmacy, using balanced blocks of 8, and will maintain control of the randomization to
ensure blinding of participants and the clinical investigators. Randomization will occur when
an order for study medication will be sent on a paper requisition to the Texas Children's
Hospital Investigational Pharmacy, and a randomization number will be assigned to correspond
to the study number. Ideally, this order will be sumbitted 24h prior to scheduled surgery,
but may be submitted for urgent cases by calling the Texas Children's Clinical Pharmacy, and
delivering the paper requisition to the 7th Floor Main Pharmacy.
The Investigational Pharmacy will prepare study medication (Tranexamic acid I.V. or Normal
saline as placebo) as determined by the randomization. The medication (whether study
medication or placebo) will be packaged in identical syringes. Sealed, opaque envelopes will
be available to the PI or an assigned designee to permit unblinding (linking randomization
number and study number) only in the event of a clinical emergency involving a study
partipant during times at which the Investigational Pharmacy is closed (nights, weekends,
holidays).
Once a patient has been randomized, the outcome in hospital will be collected even if the
study medication is interrupted or not actually given.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT04579172 -
Conservative Management of Morbidly Adherent Anterior Situated Placenta
|
N/A | |
Completed |
NCT04593303 -
Internal Iliac Artery Ligation During Management of Placenta Accreta Spectrum
|
N/A | |
Recruiting |
NCT03638024 -
Cell-free Fetal DNA Concentration in Cases of Abnormal Placental Invasion .
|
||
Not yet recruiting |
NCT06100640 -
Paracervical Pouch in Placenta Accreta Spectrum
|
||
Completed |
NCT05979181 -
Peripartum Cesarean Hysterectomy for Placenta Percreta
|
||
Recruiting |
NCT04609527 -
Management of Placenta Accreta Spectrum
|
Phase 2/Phase 3 | |
Recruiting |
NCT06185894 -
Single-step Placenta Accreta Resective Technique Tourniqueted vs Absence, Conservative Uterine Surgery
|
N/A | |
Completed |
NCT04573452 -
Galectin-3 and Placenta Accreta
|
||
Not yet recruiting |
NCT03273569 -
PDIUC Protocol for Placental Accreta
|
N/A | |
Completed |
NCT03707132 -
Tourniquet Reduces Blood Loss in Postpartum Hemorrhage During Hysterectomy for Placenta Accreta
|
||
Not yet recruiting |
NCT05104177 -
Effectivness of Conservative Techniques in Management of PAS
|
||
Completed |
NCT02806024 -
Perioperative Administration of Tranexamic Acid for Placenta Previa and Accreta Study
|
Phase 4 | |
Active, not recruiting |
NCT02784886 -
Cell-free Fetal DNA Circulating in the Maternal Plasma as a Marker for Morbidly Adherent Placenta
|
N/A | |
Recruiting |
NCT05070689 -
Placenta Accreta Spectrum Disorders: A. Chohan Continuous Squeezing Suture (ACCSS)
|
N/A | |
Completed |
NCT05813743 -
Detection of Urinary Bladder Wall Involvement in Abnormally Invasive Placenta (AIP) by 3D Ultrasonography
|
N/A | |
Withdrawn |
NCT04003428 -
Feasibility of HIFU for Management of Placenta Accreta (HIFU-ACCRETA)
|
N/A | |
Completed |
NCT04161521 -
Conservative Surgical Novel Technique of Placenta Accreta in Menoufia University Hospital
|
N/A | |
Recruiting |
NCT05139498 -
Conservative Management for PAS Pilot
|
N/A | |
Not yet recruiting |
NCT03530475 -
Diagnostic Accuracy of Doppler Ultrasound and Role of Uterine Artery Doppler
|
N/A | |
Recruiting |
NCT05922397 -
Placenta Accreta Spectrum Topographic Classification
|