A Comparison Between Bladder Dissection Before and After Uterine Incision During Cesarean Section for Placenta Accreta Spectrum: A Randomized Controlled Study

The worldwide incidence of placenta accreta spectrum is increasing, following the trend of rising caesarean delivery. It is an heterogeneous condition associated with a high maternal morbidity and mortality rate (Jauniaux et al., 2018). caesarean hysterectomy is considered the gold standard for the treatment of placenta accreta. Also this radical approach is associated with high rates of severe maternal morbidity as hemorrhage and insult to surrounding organs during surgery (Hoffman et al., 2010). Surgeons should be able to dissect the bladder safely and confidently through minimally invasive techniques, to avoid surgical injury, it is important to use anatomic landmarks, minimize the use of cauterization (Farhat and Casale, 2018). All centers are encouraged to develop guidelines to manage the potential urologic complications of these cases tailored to their resources (Taneja and Shah, 2017). This study aims to evaluate the timing of bladder dissection in caesarean section in patient with placenta accreta spectrum.

NCT Number	NCT06957184
Lead Sponsor	Ain Shams University
Conditions	Placenta Accreta
Enrollment	80 participants
Start Date	2025-05-01
Primary Completion	2026-05-01 (estimated)
Study Completion	2026-06-15 (estimated)
Updated on ClinicalTrials.gov	2025-05-04