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IRCT20230101057014N1 IRCT 2023-02-04 Yasouj University of Medical Sciences Bilateral hypogastric artery occlusion on the volume of bleeding in patients with abnormal placental adhesion Evaluation of bilateral hypogastric artery occlusion on the volume of bleeding in patients with abnormal placental adhesions 2021-10-23 anticipated 40 Complete https://irct.ir/trial/67826 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: In order to randomly select the treatment method using the kitset.ir website patients were divided into two groups and placed in their own group at the beginning of the study. In this way, first a number is considered for each patient and the first and last number and the desired number of numbers are entered in the relevant part of the mentioned site and by clicking on the number generation option, the numbers are given to us selectively and randomly. N/A Abnormal placental adhesion. Intervention 1: Intervention group: In the hypo-gastric artery ligation group, first 10 units of oxytocin are used to eutronicize the uterus, and in case of high suspicion of placental adhesion, the patient's bleeding is controlled by bilateral hypogastric artery ligation. An oncologist starts the surgery by opening the posterior peritoneum that covers the bifurcation of the common iliac vessels. Then, bilateral hypo-gastric artery ligation steps are carefully performed. Before performing this surgery and also after closing the hypogastric artery, checking the femoral pulse on both sides is done. Intervention 2: Intervention group: In the hypo-gastric artery group without ligation, cesarean surgery and hysterectomy are performed. The cesarean surgery starts by cutting the skin from the mid-line until exposing the uterus, and the fetus is delivered through the classical upper section. The umbilical cord is cut and closed by using a Kokher clip. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is It has not been decided yet.
public Parvin Ghaffari
Yasuj University of Medical Sciences, Shahid Motahari boulvared, Yasuj city, Kohgiluyeh and Boyer-Ahmad Province, Iran.
Yasuj Iran (Islamic Republic of) 7591741417 +98 71 3837 0829 pari.ghaffari@gmail.com Yasouj University of Medical Sciences scientific Parvin Ghaffari
Yasuj University of Medical Sciences, Shahid Motahari boulvared, Yasuj city, Kohgiluyeh and Boyer-Ahmad Province, Iran.
Yasuj Iran (Islamic Republic of) 7591741417 +98 71 3837 0829 pari.ghaffari@gmail.com Yasouj University of Medical Sciences Iran (Islamic Republic of) Patients with abnormal placental adhesion with Multiple Lacuna Patients with abnormal placental adhesion due to loss of the retroplacental region Patients with abnormal placental adhesion that abnormalities of the serous connection of the bladder and uterus, which will be identified through trans-abdominal and trans-vaginal ultrasonography by referring to the sonographist. no limit no limit Female Cases that have a high risk for bleeding during surgery include bleeding disorders (such as hemoglobinopathies, and thrombocytopenia) Cases receiving anticoagulant treatment, etc Cases of abnormal invasive placenta that require quick termination of pregnancy, such as heavy bleeding in the emergency department of people who have underlying diseases such as diabetes, blood pressure disorders, heart diseases, etc. Those who refused to participate in the study O00.0 Abdominal pregnancy Treatment - Surgery Treatment - Surgery Intervention group: In the hypo-gastric artery ligation group, first 10 units of oxytocin are used to eutronicize the uterus, and in case of high suspicion of placental adhesion, the patient's bleeding is controlled by bilateral hypogastric artery ligation. An oncologist starts the surgery by opening the posterior peritoneum that covers the bifurcation of the common iliac vessels. Then, bilateral hypo-gastric artery ligation steps are carefully performed. Before performing this surgery and also after closing the hypogastric artery, checking the femoral pulse on both sides is done. Intervention group: In the hypo-gastric artery group without ligation, cesarean surgery and hysterectomy are performed. The cesarean surgery starts by cutting the skin from the mid-line until exposing the uterus, and the fetus is delivered through the classical upper section. The umbilical cord is cut and closed by using a Kokher clip. The amount of bleeding volume during the surgery. Timepoint: During the surgery. Method of measurement: In order to estimate the volume of blood lost during the surgery, the volume of liquid collected in the suction device, the difference in the weight of clean and soaked in blood gauze and lung gauze and the number of towels used to control the bleeding were used. Yasouj University of Medical Sciences Approved 2021-10-16 Ethics committee of Yasuj University of Medical Sciences Deputy of research and technology of Yasuj University of Medical Sciences, Shahid Motahari boulvared, Yasuj city, Kohgiluyeh and Boyer-Ahmad Province, Iran. Yasuj Kohgilouyeh-va-Boyrahmad Iran (Islamic Republic of)