Evaluation of Clinical Outcomes and Acceptability of an Anatomical Classification for Placenta Accreta
University of California, Los Angeles
Summary
This study evaluates the clinical implementation of intra-operative topographic classification system for PAS. In addition to a standard of care risk stratification prenatal ultrasound for patients with a risk of PAS, this study adds an additional intraoperative surgical staging protocol to validate the classification system, improve surgical approach, and significantly clinical outcomes of pregnant people with an a prior risk of PAS. The study will involve pregnant patients with PAS risk factor, include data collection spanning prenatal assessment, intraoperative classification, surgical technique implementation and postoperative analysis. The anticipated study duration is approximately 36-48 months.
Description
This study is a prospective cohort study designed to assess the validity, feasibility, and clinical utility of a topographic classification system for placenta accreta spectrum (PAS), with a primary focus on its application in the actual execution of surgery. This study is investigating a clinical decision flowchart used for intraoperative staging and classification of placenta accreta spectrum (PAS) or similar uterine surgical scenarios. It integrates topographic classification, surgical decision-making, and treatment strategy selection. The classification system will directly guide and be i…
Eligibility
- Age range
- 18–55 years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * Pregnant people suspected of having PAS based on ultrasound findings or clinical risk factors * Patients undergoing planned surgical intervention for PAS, including a planned cesarean * Individuals who provide informed consent to participate in the study * Patients with at least one prenatal assessment before surgery * Expected age range: 18-55 * Patient has agreed to conservative management approach as part of standard of care if feasible intraoperatively Exclusion Criteria: * Patients who decline participation or withdraw consent * Those with contraindications to the…
Interventions
- ProcedureTotal Hysterectomy
Removal of entire uterus
- ProcedureModified subtotal hysterectomy
When partial tissue integrity is preserved
- ProcedureOne-Step Conservative Surgery
Considered when significant healthy myometrium is preserved
Location
- University of California, Los AngelesLos Angeles, California