Magnesium Sulphate Neuroprotective Strategies for Preterm Deliveries

NCT ID: NCT05674565

Last Updated: 2023-07-14

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

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

336 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-20

Study Completion Date

2024-07-15

Brief Summary

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A Cochrane systematic review has confirmed that fetal exposure to magnesium sulphate given before preterm birth has a neuroprotective role. This review also showed a significant reduction in the rate of gross motor dysfunction in early childhood. Early Preterm birth (\< 34+0 weeks) and very low birthweight (\< 1,500 g) are the principal risk factors for cerebral palsy. Multiple pregnancy accounts for over 10% of preterm births and has a higher incidence of cerebral palsy than singleton pregnancy (twins have 7 times and triplets 47 times the risk of cerebral palsy compared with singletons).

Detailed Description

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Many of these patients come or get diagnosed as eminent preterm delivery very soon before the real delivery happens and are not able to complete the recommended therapy of loading and maintenance strategy for at least complete 4 hours before delivery.

Till now, there is a gap and lack of knowledge regarding the value of loading dose only as sufficient and effective strategy for neuroprotection compared to full therapy, which needs more health costs, longer monitoring and carries more risk for the patients.

Conditions

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Premature Birth NEUROPROTECTION MAGNESIUM SULPHATE Cerebral Palsy Neonatal Death

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Loading dose only

Those receiving only the loading dose of magnesium sulphate 4 gm infusion over 20 minutes therapy within one hour before delivery without the maintenance dose

Group Type EXPERIMENTAL

Magnesium sulfate loading dose only

Intervention Type DRUG

4 gm MgSo4 loading over 20 minutes within one hour before delivery

Loading plus maintenance dose

Receiving magnesium sulphate loading 4 gm infusion over 20 minutes, followed by maintenance therapy 1gm per hour infusion until delivery or completion of 24 hours, the sooner.

Group Type EXPERIMENTAL

Magnesium sulfate loading with maintenance dose

Intervention Type DRUG

4 gm MgSo4 loading over 20 minutes followed by 1 gm per hour maintenance till delivery

Control

comparable number of women who did not receive magnesium sulphate neuroprotection for any reason

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Magnesium sulfate loading with maintenance dose

4 gm MgSo4 loading over 20 minutes followed by 1 gm per hour maintenance till delivery

Intervention Type DRUG

Magnesium sulfate loading dose only

4 gm MgSo4 loading over 20 minutes within one hour before delivery

Intervention Type DRUG

Other Intervention Names

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complete therapy short therapy

Eligibility Criteria

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Inclusion Criteria

1. Women at risk of preterm birth who are between 24+0 and 33+6 weeks of gestation.
2. When early preterm birth is planned or expected within 24 h, regardless of:

* Plurality or parity
* Reason for the risks of preterm birth
* Anticipated mode of birth
* Whether antenatal corticosteroids have been given or not

Exclusion Criteria

* Women with known Hypersensitivity to magnesium
* Caution regarding dosage for patients with renal impairment
* Preterm delivery after 34 weeks
Minimum Eligible Age

24 Weeks

Maximum Eligible Age

34 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zagazig University

OTHER_GOV

Sponsor Role lead

Responsible Party

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Hytham Atia

Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hytham Atia, M.D.

Role: STUDY_CHAIR

Zagazig University

Amro Alnemr, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zagazig University

Mohamed Lashin, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zagazig University

Sherief M El Gebaly, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zagazig University

Mohamed Arafa, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zagazig University

Locations

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Faculty of medicine, Zagazig University

Zagazig, Sharqia Province, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Hytham Atia, M.D

Role: CONTACT

+9660538308500

Amro Alnemr, M.D.

Role: CONTACT

+201224581528

Facility Contacts

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Hytham Atia, M.D.

Role: primary

References

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Shennan A, Suff N, Jacobsson B, Simpson JL, Norman J, Grobman WA, Bianchi A, Mujanja S, Valencia CM, Mol BW. FIGO good practice recommendations on magnesium sulfate administration for preterm fetal neuroprotection. Int J Gynecol Obstet. 2021;155(1):31-33. doi:10.1002/ijgo.13856.

Reference Type BACKGROUND

Usman S, Foo L, Tay J, Bennett PR, Lees C. Use of magnesium sulfate in preterm deliveries for neuroprotection of the neonate. Obstet Gynaecol. 2017;19(1):21-28. doi:10.1111/tog.12328

Reference Type BACKGROUND

Other Identifiers

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MGSULPH NEUROPROTECT EGYPT

Identifier Type: -

Identifier Source: org_study_id

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