PREGNANT Short Cervix Trial

NCT ID: NCT00615550

Last Updated: 2012-03-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

465 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-03-31

Study Completion Date

2010-11-30

Brief Summary

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The purpose of this research study is to evaluate the usefulness of progesterone vaginal gel in decreasing the preterm birth rate in a population of pregnant women with short cervical length and at high risk for preterm birth.

Detailed Description

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A Short uterine cervical length in the mid-trimester is the most powerful predictor of preterm birth.

Conditions

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Preterm Delivery Short Cervix Short Uterine Cervical Length

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo

placebo vaginal gel

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation

Prochieve

Progesterone 8% Vaginal Gel

Group Type ACTIVE_COMPARATOR

progesterone

Intervention Type DRUG

8% vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation

Interventions

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progesterone

8% vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation

Intervention Type DRUG

placebo

vaginal gel, 1.125 Grams once daily, beginning at 19 0/7 to 23 6/7 weeks gestation through 36 6/7 weeks gestation

Intervention Type DRUG

Other Intervention Names

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Prochieve 8%

Eligibility Criteria

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Inclusion Criteria

1. The subject has a short cervical length by transvaginal ultrasound (TVU) defined as 10-20mm. In cases of "dynamic cervix", the shortest observed/documented cervical length by TVU is to be used as the cervical length for inclusion purposes.
2. Singleton gestation.
3. The pregnancy has an estimated gestational age between 19 0/7 weeks and 23 6/7 weeks.
4. Maternal age between 15 (or local age of majority/emancipation) and 45 years of age at the time of screening. An alternative age range can be accepted according to the standards and applicable regulations of the study centers.
5. The subject speaks either English or a common local language.
6. The subject has voluntarily signed the Informed Consent Form and associated forms after having the contents explained, and all her questions are answered to her satisfaction and understanding.
7. In the opinion of the investigator, the subject is able to understand the study and is able to give informed consent, as well as participate in it and adhere to study procedures.

Exclusion Criteria

1. The subject has a cervical length \<10 or \>20mm.
2. The subject has a multifetal gestation.
3. The subject has or is scheduled to have a cervical cerclage prior to randomization. According to ACOG Practice Bulletin Number 48 (November 2003), cerclage can be considered in a subject with a history of 3 or more unexplained midtrimester pregnancy losses or preterm deliveries.228,229
4. Subjects diagnosed to have acute cervical insufficiency with bulging membranes passing the external os.
5. The subject has a previous history of an adverse reaction to progesterone or any component present in Prochieve® 8% vaginal gel.
6. The subject has been treated with a progestogen within the previous 4 weeks.
7. The subject is currently being treated for a seizure disorder, has an unstable psychiatric disorder, is taking antihypertensive therapy for chronic hypertension at the time of enrollment, has a history of congestive heart failure or chronic renal failure, or has uncontrolled diabetes mellitus (known end-organ dysfunction secondary to vascular disease).
8. The subject has active thrombophlebitis or a thromboembolic disorder, or a history of hormone-associated thrombophlebitis or thromboembolic disorders.
9. The subject has active liver dysfunction or disease.
10. The subject has known or suspected malignancy of the breast or genital organs.
11. The subject is currently participating in another interventional study or has participated in an interventional drug study within one month prior to screening for this study.
12. The subject's current pregnancy is complicated by a major fetal anomaly or known chromosomal abnormality.
13. The subject has a uterine anatomic malformation (bicornuate uterus, septate uterus)
14. The subject, in the judgment of the investigator, will be unable or unwilling to comply with study-related assessments and procedures.
15. The subject currently has preterm rupture of membranes, vaginal bleeding, known or suspected amnionitis, or signs or symptoms of preterm labor at the time of enrollment.
16. The subject is HIV positive with a CD4 count of \<350 cells/mm3 and is receiving more than one (1) medication to prevent the transfer of AIDS to the fetus.
17. Complete placenta previa.
Minimum Eligible Age

15 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Juniper Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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George W. Creasy, MD, FACOG

Role: STUDY_DIRECTOR

Columbia Laboratories, Inc.

Roberto Romero, MD

Role: STUDY_DIRECTOR

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Sonia Hassan, MD

Role: STUDY_DIRECTOR

Wayne State University

Locations

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University of South Alabama Dept. of OB/GYN

Mobile, Alabama, United States

Site Status

St. Joseph's Hospital and Med Ctr Women's Care Center

Phoenix, Arizona, United States

Site Status

UCI Medical Center

Orange, California, United States

Site Status

Harbor-UCLA Medical Center

Torrance, California, United States

Site Status

University of Miami Leonard Miller School of Medicine Department of Obstetrics and Gynecology

Miami, Florida, United States

Site Status

Kapi'olani Medical Center for Women and Children

Honolulu, Hawaii, United States

Site Status

Perinatal Center of Iowa

Des Moines, Iowa, United States

Site Status

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Perinatal Diagnostic Center

Lexington, Kentucky, United States

Site Status

Johns Hopkins Community Physicians

Baltimore, Maryland, United States

Site Status

Caritas St. Elizabeth's Medical Center

Boston, Massachusetts, United States

Site Status

Perinatology Research Branch Hutzel Women's Hospital

Detroit, Michigan, United States

Site Status

Henry Ford Healthcare System

Detroit, Michigan, United States

Site Status

Spectrum Health Research Department

Grand Rapids, Michigan, United States

Site Status

St. Joseph Mercy-Oakland

Pontiac, Michigan, United States

Site Status

Washington University School of Medicine, Dept. of OB/GYN

St Louis, Missouri, United States

Site Status

St. Louis University Health Sciences Center

St Louis, Missouri, United States

Site Status

Cooper University Hospital

Camden, New Jersey, United States

Site Status

Winthrop University Hosital

Mineola, New York, United States

Site Status

Albert Einstein Hospital

The Bronx, New York, United States

Site Status

Lyndhurst Clinical Research

Winston-Salem, North Carolina, United States

Site Status

UPHS Pennsylvania Hospital

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University Hospital OB/GYN / Maternal Fetal Medicine

Philadelphia, Pennsylvania, United States

Site Status

Regional Obstetrical Consultants, Chattanooga

Chattanooga, Tennessee, United States

Site Status

Regional Obstetrical Consultants, Knoxville

Knoxville, Tennessee, United States

Site Status

Eastern Virginia Medical School

Norfolk, Virginia, United States

Site Status

Charleston Area Medical Center Clinical Trials Center

Charleston, West Virginia, United States

Site Status

1st Clinical Hospital of the City of Minsk

Minsk, , Belarus

Site Status

Public Health Services Establishment "Vitebsk City Clinical Hospital of First Aid"

Vitebsk, , Belarus

Site Status

Escuela De Medicina, Pontificia Universidad Catolica De Chile

Santiago, , Chile

Site Status

Maternidad Hospital DR Sotero Del Rio

Santiago, , Chile

Site Status

Charles University & General Teaching Hospital

Prague, , Czechia

Site Status

BJ Medical College & Sassoon Hospital

Pune, Maharashtra, India

Site Status

Sri Ramchandra Medical College and Research Institute

Porur, Tamil Nadu, India

Site Status

Sheth L.G. Hospital

Ahmedabad, , India

Site Status

MediCiti Institute of Medical Sciences

Andhra Pradesh, , India

Site Status

Government Medical College

Nagpur, , India

Site Status

Soroka University Medical Center

Beersheba, , Israel

Site Status

Kaplan Medical Center

Rehovot, , Israel

Site Status

Sheba Medical Center

Tel Litwinsky, , Israel

Site Status

Azienda Ospedaliera di Padova Centro Prenatale Divisione di Ostetricia

Padua, , Italy

Site Status

Limited Liability Company "American Health Clinic"

Saint Petersburg, , Russia

Site Status

Saint Petersburg State Healthcare Institution Maternity Hospital 17

Saint Petersburg, , Russia

Site Status

Steve Biko Academic Hospital Dept. of OB-GYN and Maternal Fetal Medicine

Pretoria, , South Africa

Site Status

Municipal health care establishment "City Maternity Clinical Hospital"

Chernivtsi, , Ukraine

Site Status

Department of Obstetrics and Gynecology of Dnepropetrovsk State Medical Academy, Municipal establishment "City Maternity Hospital # 1"

Dnipro, , Ukraine

Site Status

M. Gorky Donetsk National Medical University, Department of Obstetrics, Gynecology and Perinatology, Maternity Hospital of 6th Central City Clinical Hospital

Donetsk, , Ukraine

Site Status

Municipal clinical hospital #1

Kiev, , Ukraine

Site Status

Antenatal Clinic # 1, Central Polyclinics of Pechersk District

Kyiv, , Ukraine

Site Status

Countries

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United States Belarus Chile Czechia India Israel Italy Russia South Africa Ukraine

References

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O'Brien JM, Adair CD, Lewis DF, Hall DR, Defranco EA, Fusey S, Soma-Pillay P, Porter K, How H, Schackis R, Eller D, Trivedi Y, Vanburen G, Khandelwal M, Trofatter K, Vidyadhari D, Vijayaraghavan J, Weeks J, Dattel B, Newton E, Chazotte C, Valenzuela G, Calda P, Bsharat M, Creasy GW. Progesterone vaginal gel for the reduction of recurrent preterm birth: primary results from a randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2007 Oct;30(5):687-96. doi: 10.1002/uog.5158.

Reference Type BACKGROUND
PMID: 17899572 (View on PubMed)

DeFranco EA, O'Brien JM, Adair CD, Lewis DF, Hall DR, Fusey S, Soma-Pillay P, Porter K, How H, Schakis R, Eller D, Trivedi Y, Vanburen G, Khandelwal M, Trofatter K, Vidyadhari D, Vijayaraghavan J, Weeks J, Dattel B, Newton E, Chazotte C, Valenzuela G, Calda P, Bsharat M, Creasy GW. Vaginal progesterone is associated with a decrease in risk for early preterm birth and improved neonatal outcome in women with a short cervix: a secondary analysis from a randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2007 Oct;30(5):697-705. doi: 10.1002/uog.5159.

Reference Type BACKGROUND
PMID: 17899571 (View on PubMed)

Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH; Fetal Medicine Foundation Second Trimester Screening Group. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2007 Aug 2;357(5):462-9. doi: 10.1056/NEJMoa067815.

Reference Type BACKGROUND
PMID: 17671254 (View on PubMed)

Romero R. Prevention of spontaneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment. Ultrasound Obstet Gynecol. 2007 Oct;30(5):675-86. doi: 10.1002/uog.5174. No abstract available.

Reference Type BACKGROUND
PMID: 17899585 (View on PubMed)

Hassan SS, Romero R, Vidyadhari D, Fusey S, Baxter JK, Khandelwal M, Vijayaraghavan J, Trivedi Y, Soma-Pillay P, Sambarey P, Dayal A, Potapov V, O'Brien J, Astakhov V, Yuzko O, Kinzler W, Dattel B, Sehdev H, Mazheika L, Manchulenko D, Gervasi MT, Sullivan L, Conde-Agudelo A, Phillips JA, Creasy GW; PREGNANT Trial. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2011 Jul;38(1):18-31. doi: 10.1002/uog.9017. Epub 2011 Jun 15.

Reference Type RESULT
PMID: 21472815 (View on PubMed)

Romero R, Nicolaides K, Conde-Agudelo A, Tabor A, O'Brien JM, Cetingoz E, Da Fonseca E, Creasy GW, Klein K, Rode L, Soma-Pillay P, Fusey S, Cam C, Alfirevic Z, Hassan SS. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data. Am J Obstet Gynecol. 2012 Feb;206(2):124.e1-19. doi: 10.1016/j.ajog.2011.12.003. Epub 2011 Dec 11.

Reference Type RESULT
PMID: 22284156 (View on PubMed)

Related Links

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http://onlinelibrary.wiley.com/doi/10.1002/uog.9017/pdf

Open Access to Final Study Result Publication

http://www.ajog.org/article/S0002-9378(11)02358-1/fulltext

\[Individual Patient Data Meta-analysis\] Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data

Other Identifiers

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09-CH-N014

Identifier Type: -

Identifier Source: secondary_id

COL-1620-302

Identifier Type: -

Identifier Source: org_study_id

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