Internal Iliac Artery Ligation During Management of Placenta Accreta

Status Completed

Clinical Trial Summary

Vessels ligation have been used as a part of conservative management in treatment of placenta accrete spectrum to decrease blood loss as uterine artery ligation and internal iliac artery ligation. Surgical ligation of the anterior divisions of the internal iliac artery is practiced by many tertiary care centers during management of women with PAS disorders. However there is no recommendation toward the routine use of internal iliac artery ligation before bladder dissection during conservative management of (placenta accrete spectrum). The retroperitoneal space will be dissected and bifurcation of common iliac vessels will be identified, After identifying the ureter, the internal iliac artery will be dissected on both sides away from surrounding tissues and from adjacent iliac vein. The anterior branch of each internal iliac artery will be then prophylactically ligated using suture ligation approximately 2-3 cm distal to common iliac artery bifurcation in order to avoid ligation of the posterior division. Principal investigators will conduct a study to evaluate the efficacy of internal iliac artery ligation before bladder dissection during conservative management using cervico isthmic compression suture in cases of Placenta accrete spectrum.

Clinical Trial Description

Surgical technique for all participants will be (Cervico isthmic compression suture) Steps: - Abdominal wall Incision will be done either in the midline or transverse suprapubic incision. - Opening the abdominal wall in layers. - Uterine incision will be done at the upper border of the placenta determined at laparotomy by naked eye. - Delivery of the baby. Then the placenta will be left in place till doing devascularisation and bladder dissection - Participants then will be, divided into two groups Participants in internal iliac group will undergo internal iliac artery ligation before bladder dissection Participants in no internal iliac artery group will undergo bladder dissection immediately without internal iliac artery ligation ;

Study Design

Related Conditions & MeSH terms

Placenta Accreta

Clinical Trial Details

NCT number	NCT04593303
Study type	Interventional
Source	Mansoura University Hospital
Contact
Status	Completed
Phase	N/A
Start date	September 1, 2020
Completion date	January 1, 2022

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See also
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Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Internal Iliac Artery Ligation During Management of Placenta Accreta Spectrum

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms