Planned cesarean at 37 weeks versus 36 weeks for pregnancies with placenta previa and accreta

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a multicenter, prospective, open-label randomized controlled trial enrolling pregnant women with ultrasound- and MRI-confirmed placenta previa and placenta accreta spectrum who are 28–34 weeks gestation and planned for cesarean delivery. Participants are randomized 1:1 by center, with allocation concealed using opaque sealed envelopes and analyses performed primarily by intent-to-treat with statisticians blinded to group codes. The primary efficacy outcome is a composite neonatal morbidity rate and the primary safety outcome is intraoperative estimated blood loss during cesarean delivery, with secondary outcomes including unplanned cesarean, hysterectomy, ICU admission, transfusion units, operative duration, surgical complications, reoperation, postpartum morbidity, and neonatal NICU admission. The trial tests whether delaying planned delivery to 37 weeks reduces neonatal immaturity without raising maternal hemorrhage or surgical risk.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* 28-34 weeks of gestation.
* Both ultrasound and MRI indicate placenta previa with placenta accreta spectrum (PAS).
* Planned to undergo cesarean delivery at the participating study hospitals.
* Agree to participate and sign the informed consent form.

Exclusion Criteria:

* Multiple gestation.
* Other obstetric complications (e.g., preeclampsia, vasa previa), and severe maternal medical conditions (e.g., uncontrolled diabetes, progressive cardiovascular disease, active systemic lupus erythematosus, liver cirrhosis).
* Major uterine structural anomalies (e.g., uterine didelphys, Uterine tumors ≥5 cm).
* Estimated fetal weight \<3rd percentile for gestational age, major congenital anomalies, intrauterine fetal demise.

Where it's running

• The Third Affiliated Hospital of Guangzhou Medical University
  Guangzhou, Guangdong, China Recruiting
• The First Affiliated Hospital of Zhengzhou University
  Zhengzhou, Henan, China Not yet recruiting
• West China Second University Hospital, Sichuan University
  Chengdu, Sichuan, China Not yet recruiting
• Peking University Third Hospital
  Beijing, China Not yet recruiting
• The First Affiliated Hospital of Chongqing Medical University
  Chongqing, China Not yet recruiting
• Guangzhou Women and Children's Medical Center
  Guangzhou, China Not yet recruiting

Study contacts

• Principal investigator: Zhijian Wang, MD, PhD — The Third Affiliated Hospital of Guangzhou Medical University
• Study coordinator: Qingwen Nie
• Email: nieqingwen@126.com
• Phone: +86 15622149953

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.