Feasibility and Acceptability of Risk Stratification in the Fourth Trimester to Reduce Maternal Morbidity and Mortality

NCT ID: NCT05631067

Last Updated: 2023-11-28

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

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-15

Study Completion Date

2023-06-30

Brief Summary

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Hypertensive disorders of pregnancy (HDP) are major causes of maternal morbidity and mortality globally and are associated with peripartum and future cardiovascular disease, including stroke, heart failure, and myocardial infarction. About 1 out of every 10 maternal deaths in Sub-Saharan Africa are associated with HDP, and most of these deaths are preventable with timely, implementation of evidence-based strategies, including postpartum blood pressure (BP) monitoring, treatment of elevated BP and comprehensive postpartum follow up as recommended by the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization (WHO).

This study aims to contextualize, implement, and evaluate the feasibility, fidelity, and acceptability of: 1) postpartum remote blood pressure monitoring and 2) NTproBNP testing for postpartum risk stratification in women with HDP at the University of Abuja Teaching Hospital in the Federal Capital Territory of Nigeria

Detailed Description

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Aims:

1. To evaluate the feasibility, fidelity, and acceptability of home blood pressure monitoring in postpartum patients (n=90) with HDP. The investigators hypothesize that remote blood pressure monitoring will be feasible, implemented as intended, and acceptable among patients, physicians, and other health care workers to improve awareness and early diagnosis of elevated blood pressures (\>140/90 mm Hg) in postpartum patients with HDP.
2. To evaluate the association between N Terminal-proBNP (NT-proBNP) levels and short-term cardiovascular outcomes (i.e., all-cause cardiovascular hospital readmission, postpartum pre-eclampsia, hypertensive urgency/emergency, stroke, heart failure/pulmonary edema, seizure and mortality at 12-weeks postpartum) in patients with HDP.

Conditions

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Hypertensive Disorder of Pregnancy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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BP monitoring arm

Participants will be adults \>18 years of age admitted for delivery with a diagnosis of HDP (i.e., chronic hypertension, gestational hypertension, preeclampsia, eclampsia, the HELLP syndrome, or chronic hypertension with superimposed preeclampsia) per the American College of Obstetricians and Gynecologists Criteria.

Group Type EXPERIMENTAL

Remote blood pressure monitoring

Intervention Type BEHAVIORAL

Participants will receive a blood pressure monitor to check daily BPs for two weeks post partum

NT proBNP assessment

Intervention Type DIAGNOSTIC_TEST

Participants will have biomarker assessment at 0-2 days postpartum

Control arm

Control participants will be adults \>18 years of age with an uncomplicated pregnancy and delivery, and without a diagnosis of HDP.

Group Type ACTIVE_COMPARATOR

NT proBNP assessment

Intervention Type DIAGNOSTIC_TEST

Participants will have biomarker assessment at 0-2 days postpartum

Interventions

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Remote blood pressure monitoring

Participants will receive a blood pressure monitor to check daily BPs for two weeks post partum

Intervention Type BEHAVIORAL

NT proBNP assessment

Participants will have biomarker assessment at 0-2 days postpartum

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Adults \>18 years of age
* Admitted for delivery
* Clinical diagnosis of HDP (i.e., chronic hypertension, gestational hypertension, preeclampsia, eclampsia, the HELLP syndrome, or chronic hypertension with superimposed preeclampsia)

Control participants:

* Adults \>18 years of age
* Admitted for delivery
* with an uncomplicated pregnancy and delivery

Exclusion Criteria

* Unable to provide consent
* Unable to check blood pressure at home
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Abuja Teaching Hospital

OTHER

Sponsor Role collaborator

Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Zainab Mahmoud

Instructor of Medicine (Principal Investigator)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zainab Mahmoud, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Mark D Huffman, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Dike Ojji, MBBS PhD

Role: PRINCIPAL_INVESTIGATOR

University of Abuja Teaching Hospital

Kathryn Lindley, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University

Locations

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University of Abuja Teaching Hospital

Gwagwalada, Federal Capital Territory, Nigeria

Site Status

Countries

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Nigeria

Other Identifiers

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#202207009

Identifier Type: -

Identifier Source: org_study_id