Impedance Spectroscopy for Obstetric Anal Sphincter Injuries Detection

NCT ID: NCT04181840

Last Updated: 2020-09-16

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

49 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-15

Study Completion Date

2020-07-20

Brief Summary

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The main purpose of the study is to evaluate the effectiveness and safety of the impedance spectroscopy device prototype in the detection of anal sphincter injuries in women in the early postpartum period. The study is prospective. The study group comprises up to 56 patients; up to 16 weeks from a natural delivery. The planned participation of each patient in the study is up to 4 weeks and two visits will take place at that time.

After obtaining written consent, at the first visit (V1) each patient will undergo a physical examination (both proctological and gynecological examination), blood samples for laboratory tests and stool samples for calprotectin concentration assessment will be collected. The presence of clinical symptoms of both gas and stool incontinence will be assessed during the visit with the use of Wexner's scale. Then, the dates of two reference tests will be planned: Trans-rectal USG and Recto-anal manometry which will be performed as part of the V1 visit within a period not exceeding 27 days.

The V2 visit, which will also be the final visit, will include a reassessment of the patient's general condition, recording the values of basic vital parameters, subjective and physical examination, and then the doctor conducting the examination will finally determine the extent of sphincter damage, present the patient with therapeutic options and decide on the treatment or rehabilitation of sphincter.

During the visits, all adverse events will also be monitored, both those reported by patients and those related to the examined diagnostic device.

Detailed Description

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Conditions

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Obstetric Anal Sphincter Injury Delivery Complication Obstetric Complication

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Impedance spectroscopy

Maximum 56 women up to 16 weeks from a natural delivery, with at least one perinatal anal sphincter injury risk factor, such as: the extended second delivery phase, instrumental delivery (vacuum or forceps), shoulder dystocia, birth weight of the child \> 4kg, episiotomy, uncontrolled perineal laceration (in patients with crotch protection).

The planned interventions are:

* Blood and faeces tests
* Impedance spectroscopy test
* Full gynecological and proctological examination
* Transanal ultrasonography
* Anorectal manometry

Group Type EXPERIMENTAL

Blood and faeces tests

Intervention Type DIAGNOSTIC_TEST

During V1 - Laboratory tests, particularly for calprotectin concentration assessment

Impedance spectroscopy test

Intervention Type DEVICE

During V1 - the electrical impedance of anal sphincter muscles will be measured

Full gynecological and proctological examination

Intervention Type DIAGNOSTIC_TEST

During V1 and V2 - Examination with a gynecological speculum, Two-handed examination, Rectal examination, and Anoscopy

Transanal ultrasonography

Intervention Type DIAGNOSTIC_TEST

During V1 - reference diagnostic methods with documented effectiveness and safety; for comparison with impedance spectroscopy results.

Anorectal manometry

Intervention Type DIAGNOSTIC_TEST

During V1 - reference diagnostic methods with documented effectiveness and safety; for comparison with impedance spectroscopy results.

Determining the degree of sphincter injury

Intervention Type OTHER

During V2 - conducting the examination will finally determine the extent of sphincter damage, present the patient with therapeutic options and decide on the treatment or rehabilitation of sphincter.

Interventions

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Blood and faeces tests

During V1 - Laboratory tests, particularly for calprotectin concentration assessment

Intervention Type DIAGNOSTIC_TEST

Impedance spectroscopy test

During V1 - the electrical impedance of anal sphincter muscles will be measured

Intervention Type DEVICE

Full gynecological and proctological examination

During V1 and V2 - Examination with a gynecological speculum, Two-handed examination, Rectal examination, and Anoscopy

Intervention Type DIAGNOSTIC_TEST

Transanal ultrasonography

During V1 - reference diagnostic methods with documented effectiveness and safety; for comparison with impedance spectroscopy results.

Intervention Type DIAGNOSTIC_TEST

Anorectal manometry

During V1 - reference diagnostic methods with documented effectiveness and safety; for comparison with impedance spectroscopy results.

Intervention Type DIAGNOSTIC_TEST

Determining the degree of sphincter injury

During V2 - conducting the examination will finally determine the extent of sphincter damage, present the patient with therapeutic options and decide on the treatment or rehabilitation of sphincter.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* women patients,
* 18-49 years old,
* up to 16 weeks from a natural delivery
* with the presence of:

1. clinically confirmed OASIS at least stage II, as a result of an episiotomy or uncontrolled crotch rupture (in patients with crotch protection), or
2. at least one risk factor, such as:
* the extended second delivery phase,
* instrumental delivery (vacuum or forceps),
* shoulder dystocia,
* birth weight of the child \> 4kg,
* episiotomy,
* uncontrolled perineal laceration (in patients with crotch protection),
* induction of delivery using oxytocin,
* head circumference ≥34 mm and other.
* the patient's understanding of the nature of the clinical study and permission in writing from the patient to participate in this study.

Exclusion Criteria

* the presence of acute diseases during treatment,
* the presence of chronic diseases not treated or treated insufficiently (e.g., incorrectly controlled hypertension),
* the presence of diseases with accompanying symptoms of fecal incontinence history of proctology surgery's whit postoperative complication,
* the presence of inflammatory bowel diseases during the exacerbation phase,
* the treatment in the last year because of serious, progressive, uncontrolled cardiological, pulmonary, nephrology, contagious or psychiatric illness whose course could affect the patient's risk increase due to participation in the study,
* significant disease symptoms so far undiagnosed,
* the presence or suspected malignant disease or previous on previous oncological treatment in the last 5 years,
* the presence of a cardiac stimulator or cardioverter-defibrillator,
* severe surgery or severe trauma in the last year.
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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OASIS Diagnostics S.A.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Małgorzata Uchman-Musielak, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Specialist Medical Practice

Locations

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Praktyka Lekarska Małgorzata Uchman-Musielak

Warsaw, Masovian Voivodeship, Poland

Site Status

Countries

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Poland

Related Links

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Other Identifiers

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2/1/2019 (May 6)

Identifier Type: -

Identifier Source: org_study_id

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