Cerclage for Prevention on Preterm Birth in Women With Placenta Previa

NCT ID: NCT01442207

Last Updated: 2014-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

2012-03-31

Study Completion Date

2013-05-31

Brief Summary

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The purpose of the study is to compare the role of cervical cerclage versus expectant management in women with complete placenta previa (≥ 10mm over internal os) presenting with shortened cervical length ( ≥ 10mm and ≤ 30mm) between 18w0d and 26w0d of pregnancy.

Detailed Description

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The purpose of this study is to perform a large multi-center randomized trial comparing the role of cervical cerclage versus expectant management in women with placenta previa presenting with shortened cervical length ( ≥ 10mm and ≤ 30mm) between 18w0d and 26w0d of gestation. In addition, the role of fetal fibronectin (fFN) for the prediction of preterm birth and hemorrhage will be elucidated. The hypothesis is that placement of a cervical cerclage between 18w0d to 26w0d in patients with a short cervix and complete placenta previa will decrease preterm birth as compared to expectantly managing these patients.

Conditions

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Premature Birth Placenta Previa

Keywords

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Premature Birth Placenta Previa

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Expectant Management

Participants assigned to the expectant management group will be followed by their doctor and managed per standard management which includes:

* Standard management for placenta previa.
* Hospital admission for vaginal bleeding/hemorrhage
* Antenatal corticosteroids \> 24w0d of gestation
* Tocolytic therapy per physician's discretion
* Magnesium sulfate for neuroprotection
* Fetal Heart Rate Monitoring
* Avoidance of digital examinations of the cervix
* Elective delivery no earlier than 36w0d gestation unless indicated (uncontrolled hemorrhage, imminent delivery, Premature rupture of the membranes (PROM) \> 34 wks, worsening maternal or fetal condition )
* Fetal Fibronectin (fFN) test collected at the time of transvaginal Ultrasound.

Group Type PLACEBO_COMPARATOR

Standard Expectant Management

Intervention Type PROCEDURE

Participants assigned to the expectant management group will be followed by their doctor and managed per standard management which includes:

* Standard management for placenta previa.
* Hospital admission for vaginal bleeding/hemorrhage
* Antenatal corticosteroids \> 24w0d of gestation
* Tocolytic therapy per physician's discretion
* Magnesium sulfate for neuroprotection
* Fetal Heart Rate Monitoring
* Avoidance of digital examinations of the cervix
* Elective delivery no earlier than 36w0d gestation unless indicated (uncontrolled hemorrhage, imminent delivery, PROM \> 34 wks, worsening maternal or fetal condition )
* Fetal Fibronectin (fFN) test collected at the time of transvaginal Ultrasound.

Placement of Cervical Cerclage

Cervical Cerclage is to be placed in an inpatient hospital setting within 24 to 72 hours of being assigned to this treatment group

Group Type ACTIVE_COMPARATOR

Placement of a Cervical Cerclage

Intervention Type PROCEDURE

Surgical placement of a cervical cerclage

Interventions

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Placement of a Cervical Cerclage

Surgical placement of a cervical cerclage

Intervention Type PROCEDURE

Standard Expectant Management

Participants assigned to the expectant management group will be followed by their doctor and managed per standard management which includes:

* Standard management for placenta previa.
* Hospital admission for vaginal bleeding/hemorrhage
* Antenatal corticosteroids \> 24w0d of gestation
* Tocolytic therapy per physician's discretion
* Magnesium sulfate for neuroprotection
* Fetal Heart Rate Monitoring
* Avoidance of digital examinations of the cervix
* Elective delivery no earlier than 36w0d gestation unless indicated (uncontrolled hemorrhage, imminent delivery, PROM \> 34 wks, worsening maternal or fetal condition )
* Fetal Fibronectin (fFN) test collected at the time of transvaginal Ultrasound.

Intervention Type PROCEDURE

Other Intervention Names

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cerclage Expectant Management

Eligibility Criteria

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Inclusion Criteria

* Singleton pregnancy, ≥ 18yrs old
* GA 18w0d to 26w0d inclusive @ time of enrollment
* Documentation of complete placenta previa (≥ 10mm over internal os)
* Agrees to participate in trial and signs/date an informed consent form.

Exclusion Criteria

* Contraindication to expectant management (i.e. active labor, Non-reassuring fetal heart rate (NRFHR), Intrauterine fetal demise (IUFD), uncontrolled hemorrhage)
* Fetal condition likely to cause serious neonatal morbidity independent of GA (e.g. hydrops, fetal viral infections, fetal malformations likely to need surgery like hydrocephalus, neural tube defects, cardiac defects, abdominal wall defects)
* Known uterine anomaly at time of enrollment
* History of two or more prior cesarean deliveries
* Suspected placenta accrete, increta or percreta on US at enrollment
* Cervical cerclage present at time of enrollment
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Obstetrix Medical Group

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Irene Stafford, MD

Role: PRINCIPAL_INVESTIGATOR

Obstetrix Medical Group of Tucson.

Countries

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United States

Other Identifiers

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OBX 0018

Identifier Type: -

Identifier Source: org_study_id