An anatomical system to guide surgery for placenta accreta
Evaluation of Clinical Outcomes and Acceptability of an Anatomical Classification for Placenta Accreta
This project will try using an intraoperative anatomical classification to help surgeons choose the safest operation for pregnant people at risk of placenta accreta.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 60 (estimated) |
| Ages | 18 Years to 55 Years |
| Sex | Female |
| Sponsor | University of California, Los Angeles Academic / other |
| Locations | 1 site (Los Angeles, California) |
| Trial ID | NCT07283042 on ClinicalTrials.gov |
What this trial studies
This is a prospective cohort study that integrates prenatal ultrasound staging with a structured intraoperative topographic classification to guide surgical decision-making for placenta accreta spectrum. Patients undergo standardized prenatal assessment, real-time intraoperative staging with photos and videos, and then surgical management chosen according to the classification (from cesarean hysterectomy to one-step conservative procedures). The study will collect intraoperative blood loss metrics, correlate surgical findings with pathology, and compare preoperative ultrasound to intraoperative and postoperative data to validate the system. Data collection and follow-up are planned over approximately 36–48 months to assess feasibility, acceptability, and clinical outcomes.
Who should consider this trial
Good fit: Pregnant people aged 18–55 with prenatal ultrasound or clinical risk factors for placenta accreta who plan surgical management and can provide informed consent are ideal candidates.
Not a fit: People without prenatal PAS risk factors, those managed nonoperatively, or those who cannot undergo planned surgery at the study site are unlikely to benefit from this intraoperative classification.
Why it matters
Potential benefit: If successful, the classification could help surgeons pick procedures that reduce blood loss and complications and improve surgical outcomes for people with placenta accreta.
How similar studies have performed: Related ultrasound-based staging systems have been described, but real-time intraoperative topographic classification and its formal validation in surgical decision-making remain relatively novel with limited prior evidence.
Eligibility criteria
Show full inclusion / exclusion criteria
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 planned surgical procedure
Where this trial is running
Los Angeles, California
- University of California, Los Angeles — Los Angeles, California, United States (Recruiting)
Study contacts
- Principal investigator: Yalda Afshar, MD, PhD — University of California, Los Angeles
- Study coordinator: Dana Levin-Lopez, MPH
- Email: dlevinlopez@mednet.ucla.edu
- Phone: 310-794-8893
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.