Can the Use of a Next Generation Partograph Improve Neonatal Outcomes? (PICRINO)

NCT ID: NCT05560802

Last Updated: 2024-10-22

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

RECRUITING

Clinical Phase

NA

Total Enrollment

120000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-15

Study Completion Date

2027-09-30

Brief Summary

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The overall aim is to evaluate the impact of the use of two different guidelines for monitoring labor progress, the WHOs LCG versus standard care, on neonatal and maternal outcomes. The hypothesis is that the use of LCG will reduce adverse neonatal outcomes and decrease the number of intrapartum Cesarean sections compared with standard care.

Secondly, other perinatal interventions and complications will be compared between the LCG and standard care groups, as well as economic considerations. This will be investigated using a multicenter, stepped-wedge cluster randomized trial design.

In addition, the project will explore a series of quantitative and qualitative research questions to gain in-depth knowledge about experiences and perceptions about childbirth and the use of LCG. These research questions will be investigated using questionnaires, focus group and individual interviews with providers, partners and women that have gone through childbirth.

Detailed Description

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Study Title

Can the use of a next generation partograph based on WHO's latest intrapartum care recommendations improve neonatal outcomes? A stepped-wedge cluster randomized trial (PICRINO).

Primary Objectives

To compare two different guidelines for monitoring labor progress, the the World Health Organization (WHO)'s Labour Care Guide (LCG) with standard care, and evaluate:

Adverse neonatal outcome, a composite outcome of perinatal mortality and neonatal morbidity. Neonatal morbidity will include five-minute Apgar score \<7, hypoxic ischemic encephalopathy II-III, intracranial hemorrhage, neonatal seizures, meconium aspiration syndrome, and admission to a neonatal unit.

The rate of intrapartum cesarean section.

Secondary Objectives

Secondary outcomes will be a composite of severe neonatal outcomes including five-minute Apgar score \<4, hypoxic ischemic encephalopathy II-III, intracranial hemorrhage, neonatal seizures and meconium aspiration syndrome and other relevant neonatal outcomes.

Obstetric outcomes will be mode of delivery, oxytocin use, postpartum hemorrhage, perineal laceration (grade II-IV), duration of labor, women´s and partner´s experiences of childbirth, healthcare providers experiences of and compliance to LCG and economic considerations.

Study Design

A multicenter, stepped-wedge cluster randomized trial.

Study Population

All women in active labor at participating delivery units in Sweden.

Power analysis

With significance level 0.05, the power to detect the anticipated risk reduction (20%) would be \>0.999.

Study Duration

2023-2025

Conditions

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Neonatal Complication Labor (Obstetrics)--Complications

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

multicenter, stepped-wedge cluster randomized trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Labour care guide

According to WHO guidelines

Group Type EXPERIMENTAL

WHOs Labour care guide

Intervention Type OTHER

Guidelines for monitoring labor progress, the WHOs LCG

Standard care

Standard delivery care in Sweden

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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WHOs Labour care guide

Guidelines for monitoring labor progress, the WHOs LCG

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

-All women in active labor
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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The Swedish Research Council

OTHER_GOV

Sponsor Role collaborator

Linkoeping University

OTHER_GOV

Sponsor Role lead

Responsible Party

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Marie Blomberg

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marie Blomberg, Professor

Role: PRINCIPAL_INVESTIGATOR

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Locations

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Eksjö höglandssjukhuset

Eksjö, , Sweden

Site Status RECRUITING

Falu Lasarett

Falun, , Sweden

Site Status RECRUITING

Gällivare sjukhus

Gällivare, , Sweden

Site Status RECRUITING

Göteborg Salgrenska Universitetssjukhuset

Gothenburg, , Sweden

Site Status RECRUITING

Helsingborgs lasarett

Helsingborg, , Sweden

Site Status RECRUITING

Huddinge Karolinska universitetssjukhus

Huddinge, , Sweden

Site Status RECRUITING

Hudiksvalls sjukhus

Hudiksvall, , Sweden

Site Status RECRUITING

Jönköping Länssjukhuset Ryhov

Jönköping, , Sweden

Site Status RECRUITING

Länssjukhuset

Kalmar, , Sweden

Site Status RECRUITING

Kristianstad centralsjukhus

Kristianstad, , Sweden

Site Status RECRUITING

Linköpings universitetssjukhus

Linköping, , Sweden

Site Status RECRUITING

Lund Skånes universitetssjukhus

Lund, , Sweden

Site Status RECRUITING

Skellefteå Lasarett

Skellefteå, , Sweden

Site Status RECRUITING

Södertälje Sjukhus

Södertälje, , Sweden

Site Status RECRUITING

Sunderby sjukhus

Södra Sunderbyn, , Sweden

Site Status RECRUITING

BB Stockholm

Stockholm, , Sweden

Site Status RECRUITING

Stockholm Södersjukhuset

Stockholm, , Sweden

Site Status RECRUITING

Umeå Norrlands universitetssjukhus

Umeå, , Sweden

Site Status RECRUITING

Akademiska sjukhuset

Uppsala, , Sweden

Site Status RECRUITING

Värnamo sjukhus

Värnamo, , Sweden

Site Status RECRUITING

Västerviks sjukhus

Västervik, , Sweden

Site Status RECRUITING

Visby Lasarett

Visby, , Sweden

Site Status RECRUITING

Ystad Lasarett

Ystad, , Sweden

Site Status RECRUITING

Vrinnevisjukhuset

Norrköping, Östergötland County, Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Marie Blomberg, Professor

Role: CONTACT

+4613288956

Anna Ramö Isgren, pHD

Role: CONTACT

Facility Contacts

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Emma Lindqvist

Role: primary

Emma Åkerlund

Role: primary

Malin Strand

Role: primary

Radha Korsoski

Role: primary

Tony Lavesson

Role: primary

Cecilia Johansson

Role: primary

Zoltan Zavaczki

Role: primary

Maria Wärnsberg

Role: primary

Maria Svenvik

Role: primary

Christina Vallen

Role: primary

Eric Hildebrand

Role: primary

Anna Bonnevier

Role: primary

Caisa Söderholm Edström

Role: primary

Malin Öndemark

Role: primary

Malin Strand

Role: primary

Katarina Remaeus

Role: primary

Hanna Åmark

Role: primary

Linnea Åström

Role: primary

Mariella Öberg

Role: primary

Elin Boozon

Role: primary

Maria Källman

Role: primary

Åsa Hedqvist

Role: primary

Marie Carlsson

Role: primary

Ulrica Ottosson

Role: primary

References

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WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. Available from http://www.ncbi.nlm.nih.gov/books/NBK513809/

Reference Type BACKGROUND
PMID: 30070803 (View on PubMed)

Vogel JP, Comrie-Thomson L, Pingray V, Gadama L, Galadanci H, Goudar S, Laisser R, Lavender T, Lissauer D, Misra S, Pujar Y, Qureshi ZP, Amole T, Berrueta M, Dankishiya F, Gwako G, Homer CSE, Jobanputra J, Meja S, Nigri C, Mohaptra V, Osoti A, Roberti J, Solomon D, Suleiman M, Robbers G, Sutherland S, Vernekar S, Althabe F, Bonet M, Oladapo OT. Usability, acceptability, and feasibility of the World Health Organization Labour Care Guide: A mixed-methods, multicountry evaluation. Birth. 2021 Mar;48(1):66-75. doi: 10.1111/birt.12511. Epub 2020 Nov 22.

Reference Type BACKGROUND
PMID: 33225484 (View on PubMed)

Isgren AR, Korsoski R, Abrahamsson T, Wendel SB, Kallen K, Lundborg L, Remaeus K, Thomas K, Wikstrom AK, Carlsson Y, Blomberg M. Can the use of a next generation partograph based on WHO's latest intrapartum care recommendations improve neonatal outcomes? (PICRINO) Study protocol for a stepped-wedge cluster randomized trial. PLoS One. 2025 Mar 4;20(3):e0316336. doi: 10.1371/journal.pone.0316336. eCollection 2025.

Reference Type DERIVED
PMID: 40036215 (View on PubMed)

Other Identifiers

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Picrino2022

Identifier Type: -

Identifier Source: org_study_id

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