Introduction of UBT for PPH Management in Three Countries

NCT ID: NCT02910310

Last Updated: 2018-07-26

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

COMPLETED

Clinical Phase

NA

Total Enrollment

60105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-31

Study Completion Date

2018-03-31

Brief Summary

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This study is a prospective, systematic evaluation to assess the effectiveness and safety of introduction of UBT into PPH care at secondary level and district hospitals in 3 low-resource countries. The first component of the evaluation is a prospective stepped wedge cluster randomized design to assess the potential reduction in PPH-related mortality and invasive procedures (blood transfusion, arterial ligation, hysterectomy and uterine arterial embolization) for PPH performed at participating facilities following introduction of UBT. The second component is a nested cohort analysis to assess the safety and acceptability of UBT among women diagnosed with PPH.

Detailed Description

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To assess the effectiveness of introduction of the UBT, a stepped wedge cluster randomized design will be employed to monitor maternal health outcomes among vaginal deliveries occurring at all participating facilities during the study phases described below:

Baseline phase: A baseline phase will be conducted in all participating sites before training and introduction of the UBT for PPH management. This phase will consist of prospective data collection to establish the baseline rates of key study outcomes.

Step 1 intervention phase: In this phase, participating sites will be randomized such that half will receive training on use of the UBT for PPH management with subsequent introduction into their standard practice and half will continue data collection without UBT introduction.

Step 2 intervention phase: In this phase, the remaining sites will receive training on use of the UBT for PPH management with subsequent introduction into their standard practice. During this phase, all participating sites will continue data collection to document study outcomes and all will be using UBT in their standard practice.

To assess the safety and acceptability of the use of UBT for PPH management, a nested cohort analysis will be done among women diagnosed with PPH during the stepped wedge trial. The investigators will assess the rates of treatment of postpartum infection and examine acceptability of care provided among the following two cohorts of women:

UBT group: All women diagnosed with PPH following a vaginal delivery and who have an attempted UBT placement (including successful or unsuccessful placements).

No-UBT group: All women diagnosed with PPH following a vaginal delivery that do not have an attempted UBT placement.

Conditions

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Postpartum Hemorrhage

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Baseline period

The baseline period will involve data collection on study outcomes before uterine balloon tamponade (UBT) is introduced at study sites.

Group Type NO_INTERVENTION

No interventions assigned to this group

Uterine balloon tamponade

The UBT period will involve data collection on study outcomes after providers at sites are trained on UBT use and UBT is introduced into PPH management practice at study sites.

Group Type EXPERIMENTAL

Uterine balloon tamponade

Intervention Type OTHER

An intervention consisting of inserting a condom attached to a urinary catheter into the uterus and inflating it with fluid to stop postpartum bleeding

Interventions

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Uterine balloon tamponade

An intervention consisting of inserting a condom attached to a urinary catheter into the uterus and inflating it with fluid to stop postpartum bleeding

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Vaginal delivery at participating facility or referred to participating facility for PPH after vaginal delivery elsewhere


* Vaginal delivery at participating facility or referred to participating facility for PPH after vaginal delivery elsewhere
* Diagnosed and treated for PPH during the stepped wedge trial
* Willing and able to give informed consent
* Agree to participate in a postpartum interview before hospital discharge
* Agree to brief follow-up interview 4 weeks after delivery

Exclusion Criteria

* Delivery via Cesarean section
* Transferred to another facility before delivery
* Transferred to the participating facility after vaginal delivery elsewhere but died before arrival

Eligibility for nested cohort analysis:


* Delivery via Cesarean section
* Transferred to another facility before delivery
* Transferred to the participating facility after vaginal delivery elsewhere but died before arrival
Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Ministry of Health and Population, Egypt

OTHER_GOV

Sponsor Role collaborator

Alexandria University

OTHER

Sponsor Role collaborator

El Galaa Teaching Hospital

OTHER

Sponsor Role collaborator

Global Health Uganda LTD

OTHER

Sponsor Role collaborator

Makerere University

OTHER

Sponsor Role collaborator

Ministry of Health, Uganda

OTHER_GOV

Sponsor Role collaborator

Ministere de la Sante et des Services Sociaux

OTHER

Sponsor Role collaborator

Gynuity Health Projects

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Holly Anger, MPH

Role: PRINCIPAL_INVESTIGATOR

Gynuity Health Projects

Rasha Dabash, MPH

Role: PRINCIPAL_INVESTIGATOR

Gynuity Health Projects

Laura Frye, MPH

Role: PRINCIPAL_INVESTIGATOR

Gynuity Health Projects

Ayisha Diop, MPH

Role: PRINCIPAL_INVESTIGATOR

Gynuity Health Projects

Sam Ononge, MD

Role: PRINCIPAL_INVESTIGATOR

Makerere University

Nevine Hassanien, MD

Role: PRINCIPAL_INVESTIGATOR

Consultant

Mohamed Cherine Ramadan, MD

Role: PRINCIPAL_INVESTIGATOR

El Galaa Teaching Hospital

Emad Darwish, MD

Role: PRINCIPAL_INVESTIGATOR

Alexandria University

Bocar Daff, MD

Role: PRINCIPAL_INVESTIGATOR

Ministry of Health, Senegal

Beverly Winikoff, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Gynuity Health Projects

Locations

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Abu Hummus Hospital

Abū Ḩummuş, , Egypt

Site Status

Fayoum General Hospital

Al Fayyum, , Egypt

Site Status

Ismailia General Hospital

Ismailia, , Egypt

Site Status

Itsa Hospital

Iţsā, , Egypt

Site Status

Etay el Barood Hospital

Ītāy al Bārūd, , Egypt

Site Status

Kafr el Dawar Hospital

Kafr El Dawar, , Egypt

Site Status

Centre de Santé Gaspard Camara

Dakar, , Senegal

Site Status

Centre de Santé Nabil Choucair

Dakar, , Senegal

Site Status

Centre de Santé Philip Maguilene Senghor

Dakar, , Senegal

Site Status

Hôpital Roi Boudoin

Dakar, , Senegal

Site Status

Centre de Santé Tefess Mbour

Mbour, , Senegal

Site Status

Hôpital Régional de Mbour

Mbour, , Senegal

Site Status

Gombe Hospital

Gombe, , Uganda

Site Status

Itojo Hospital

Itojo, , Uganda

Site Status

Kiryandongo Hospital

Kiryandongo, , Uganda

Site Status

Kitagata Hospital

Kitagata, , Uganda

Site Status

Lyantonde Hospital

Lyantonde, , Uganda

Site Status

Masindi Hospital

Masindi, , Uganda

Site Status

Countries

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Egypt Senegal Uganda

References

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Kellie FJ, Wandabwa JN, Mousa HA, Weeks AD. Mechanical and surgical interventions for treating primary postpartum haemorrhage. Cochrane Database Syst Rev. 2020 Jul 1;7(7):CD013663. doi: 10.1002/14651858.CD013663.

Reference Type DERIVED
PMID: 32609374 (View on PubMed)

Other Identifiers

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3005

Identifier Type: -

Identifier Source: org_study_id

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