Placenta Accreta ManagementNCT07706062
Total Lower Uterine Segmentectomy With Adjunctive Mechanical Towel Compression for the Surgical Management of Placenta Accreta Spectrum Disorders
An observational study of Placenta Accreta Management, run by Assiut University.
Trial summary
The goal of this observational study is to evaluate the feasibility and safety of utilizing adjunctive mechanical towel compression during TLS-CCA, measured primarily by estimated intraoperative blood loss in patient with Maternal age 18-45 years - Singleton pregnancy - Antenatal diagnosis of PAS (ultrasound ± MRI) … Read more about this study
- Who is it for?
- Ages 18 to 45 years, women only
- Conditions the study is for
- Placenta Accreta Management
- How many people
- 30 participants
- Where
- No sites listed yet
- Study dates
- 1 Sep 2026to 1 Dec 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- Women only
- Adult
Study population: A consecutive series of pregnant women with an antenatal diagnosis of PAS scheduled for elective, uterus-preserving surgical management via TLS-CCA utilizing the novel towel compression technique
Who may be able to join
- Maternal age 18-45 years
- Singleton pregnancy
- Antenatal diagnosis of PAS (ultrasound ± MRI)
- Planned elective cesarean delivery
- Candidate for uterine preservation via TLS-CCA
- Provided written informed consent
Who cannot join
- Hemodynamic instability necessitating emergency hysterectomy
- Placental invasion into adjacent pelvic organs requiring exenteration
- Pre-existing severe coagulation disorders
- Multiple gestation or major fetal anomalies
- Patient refusal to participate
About this study
Official title: Total Lower Uterine Segmentectomy With Adjunctive Mechanical Towel Compression for the Surgical Management of Placenta Accreta Spectrum Disorders: A Case Series
The goal of this observational study is to evaluate the feasibility and safety of utilizing adjunctive mechanical towel compression during TLS-CCA, measured primarily by estimated intraoperative blood loss in patient with Maternal age 18-45 years - Singleton pregnancy - Antenatal diagnosis of PAS (ultrasound ± MRI) - Planned elective cesarean delivery - Candidate for uterine preservation via TLS-CCA - Provided written informed consent
Read the detailed description
Placenta accreta spectrum (PAS) disorders, characterized by abnormal trophoblastic invasion into the myometrium, have seen a global rise in incidence primarily driven by increasing cesarean delivery rates. Massive obstetric hemorrhage remains the leading cause of maternal morbidity and mortality in these cases.
While cesarean hysterectomy is the traditional gold standard for severe PAS, uteruspreserving procedures are increasingly preferred by patients desiring future fertility. Total lower uterine segmentectomy with cervico-corporeal anastomosis (TLS-CCA) is a recognized conservative technique that involves excising the invaded lower segment and reconstructing the uterus. Despite removing the primary placental implantation site, diffuse bleeding from the highly vascularized remaining myometrial bed, dissected bladder flap, and pelvic collateral vessels often persists. While traditional compression sutures or specialized devices are utilized for hemostasis, they can be costly or technically challenging in distorted anatomies. This study introduces a novel, simple, and cost-effective approach: the use of tightly rolled sterile surgical towelsapplied as direct mechanical compression against the lower uterine segment and bladder bed during dissection and reconstruction.
- Conditions
- Placenta Accreta Management
- Keywords
- placenta accreta
- Medical subject headings
- Placenta Accreta
What is being measured
The primary outcome is the main question the study is designed to answer.
Estimated intraoperative blood loss
Estimated intraoperative blood loss by (mL)
Measured: at operation
Secondary outcomes (1)
Blood transfusion requirements
Blood transfusion requirements (units of packed RBCs and FFP)
Measured: intraoperative
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jul 2026
- Study start1 Sep 2026 (estimated)
- Primary completion1 Sep 2027 (estimated)
- Study completion1 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Placenta Accreta ManagementStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Prospective
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Nourhan Karam Hussein Al Salmany, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07706062
- Sponsor's protocol ID
- Nourhan
- Status last verified
- Jul 2026
- First submitted
- 10 Jul 2026
- Last updated
- 27 Jul 2026
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Total Lower Uterine Segmentectomy With Adjunctive Mechanical Towel Compression for the Surgical Management of Placenta Accreta Spectrum Disorders: A Case Series
- ClinicalTrials.gov ID
- NCT07706062
- Acronym / sponsor ID
- Nourhan
- Conditions
- Placenta Accreta Management
- Keywords
- placenta accreta
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- 1 Sep 2026 (estimated)
- Primary completion
- 1 Sep 2027 (estimated)
- Study completion
- 1 Dec 2027 (estimated)
- First posted
- 15 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this observational study is to evaluate the feasibility and safety of utilizing adjunctive mechanical towel compression during TLS-CCA, measured primarily by estimated intraoperative blood loss in patient with Maternal age 18-45 years - Singleton pregnancy - Antenatal diagnosis of PAS (ultrasound ± MRI) - Planned elective cesarean delivery - Candidate for uterine preservation via TLS-CCA - Provided written informed consent
Detailed description
Placenta accreta spectrum (PAS) disorders, characterized by abnormal trophoblastic invasion into the myometrium, have seen a global rise in incidence primarily driven by increasing cesarean delivery rates. Massive obstetric hemorrhage remains the leading cause of maternal morbidity and mortality in these cases.
While cesarean hysterectomy is the traditional gold standard for severe PAS, uteruspreserving procedures are increasingly preferred by patients desiring future fertility. Total lower uterine segmentectomy with cervico-corporeal anastomosis (TLS-CCA) is a recognized conservative technique that involves excising the invaded lower segment and reconstructing the uterus. Despite removing the primary placental implantation site, diffuse bleeding from the highly vascularized remaining myometrial bed, dissected bladder flap, and pelvic collateral vessels often persists. While traditional compression sutures or specialized devices are utilized for hemostasis, they can be costly or technically challenging in distorted anatomies. This study introduces a novel, simple, and cost-effective approach: the use of tightly rolled sterile surgical towelsapplied as direct mechanical compression against the lower uterine segment and bladder bed during dissection and reconstruction.
Study design
- Observational model
- Other
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 to 45 years
- Sex
- Female only
- Age groups
- Adult
- Study population
- A consecutive series of pregnant women with an antenatal diagnosis of PAS scheduled for elective, uterus-preserving surgical management via TLS-CCA utilizing the novel towel compression technique
Key inclusion criteria (6 listed)
- Maternal age 18-45 years
- Singleton pregnancy
- Antenatal diagnosis of PAS (ultrasound ± MRI)
- Planned elective cesarean delivery
- Candidate for uterine preservation via TLS-CCA
Key exclusion criteria (5 listed)
- Hemodynamic instability necessitating emergency hysterectomy
- Placental invasion into adjacent pelvic organs requiring exenteration
- Pre-existing severe coagulation disorders
- Multiple gestation or major fetal anomalies
- Patient refusal to participate
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Estimated intraoperative blood loss
Time frame: at operation
Estimated intraoperative blood loss by (mL)
1 secondary outcome
Blood transfusion requirements
Time frame: intraoperative
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Jul 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Placenta Accreta Management, run by Assiut University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 27 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Estimated intraoperative blood loss (time frame: at operation). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jul 2026.