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

"All caesarean sections will be performed by a surgeon who has experience in performing caesarean hysterectomy in both groups.~* Scrubbing the abdomen as usual.~* Subumblical midline skin incision versus Pfannenstiel incision will be chosen according to site of the placenta and previous surgeries.~* In group A careful bladder dissection will be done before uterine incision with ensuring hemostasis, uterine incision will be done above the placenta, after delivering the baby awaiting for placental separation if not proceeding for caesarean hysterectomy.~* In group B uterine incision will be done above the placenta and after delivering the baby awaiting for placental separation if not proceeding to caesarean hysterectomy and dissecting bladder just before clamping uterine artery."