Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH (TRANOXY2016)
Primary Purpose
Post Partum Haemorrhage
Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Tranexamic Acid
Oxytocin
Sponsored by
About this trial
This is an interventional treatment trial for Post Partum Haemorrhage focused on measuring TXA, PPH
Eligibility Criteria
Inclusion Criteria:
- Subjects at the end of pregnancy ( 37-42 w ) at low risk of PPH Mean by low-risk of PPH subjects without any of the following risk factors : hypertension/preeclampsia, placental abruption during pregnancy , placenta previa , tocolysis two hours before delivery, multiple pregnancy , previous PPH, obesity ( BMI > 35 ), anemia (Hb < 7 g/dL), elective caesarean section , induction of labor, retention of placental material , polyhydramnios , fever during labor, use of high doses of heparin low molecular weight.
- Subjects full capacity and the willingness to give written informed consent .
Exclusion Criteria:
- Subjects with preterm pregnancy (<37 weeks ) or with prolonged pregnancy ( > 42 weeks )
- Subjects at the end of pregnancy ( 37 weeks - 42 weeks ) with the following risk factors for PPH (Tab1.Protocol Study, vers.2.0 of 07/05/2016)
- multiple pregnancy
- History of thromboembolic disease or high incidence of thromboembolic events in family history ( patients at high risk of thrombophilia )
- Patients with Long - QT syndrome or who are taking drugs that cause QT prolongation
- Intrauterine fetal Death
- Epilepsy
- Autoimmune disease Tab1 medical history :
- Placental abruption during pregnancy
- Placenta previa
- Hypertension / preeclampsia
- Previous PPH
- Polyhydramnios
- Obesity ( BMI > 35 )
- Anemia ( < 7 g / dL )
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
arm A (TXA)
arm B (OXY)
Arm Description
2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery(third stage after labor)
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
Outcomes
Primary Outcome Measures
assessment of total blood loss expressed in mL
global blood loss > 500 mL
assessment of total blood loss expressed in mL
global blood loss > 500 mL
Secondary Outcome Measures
assessment of the number of hemodynamic changes
hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )
assessment of the number of hemodynamic changes
increased heart rate (number of women with Heart Rate > 60 bpm )
assessment of the need of using additional uterotonic
administration additional drug for the treatment of PPH
assessment of the need of using additional uterotonic
administration additional drug for the treatment of PPH
assessment the need for surgical manoeuvres for the bleeding control
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
assessment the need for surgical manoeuvres for the bleeding control
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
assessment the need for the blood transfusions
Hb <7 g/dL
evaluation of the number of cases in which the following was seen verified:
nausea between delivery and discharge vomiting between birth and discharge headache between birth and discharge dyspnoea between birth and discharge Chest pain between birth and discharge endometritis after delivery (assessed by monitoring body temperature)
Full Information
NCT ID
NCT02775773
First Posted
May 16, 2016
Last Updated
January 20, 2017
Sponsor
Azienda U.S.L. 1 di Massa e Carrara
1. Study Identification
Unique Protocol Identification Number
NCT02775773
Brief Title
Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH
Acronym
TRANOXY2016
Official Title
Longitudinal Clinical, Controlled, Randomized, Open-label, Phase III Study to Assess the Equivalence of Tranexamic Acid (TXA) vs Oxytocin (OXY) in Reducing Post Partum Haemorrhage (PPH) in Patients at the End of Pregnancy (37-42 w), at Low Risk of PPH
Study Type
Interventional
2. Study Status
Record Verification Date
May 2016
Overall Recruitment Status
Unknown status
Study Start Date
January 1, 2017 (Actual)
Primary Completion Date
December 31, 2017 (Anticipated)
Study Completion Date
December 31, 2018 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Azienda U.S.L. 1 di Massa e Carrara
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study was to evaluate that the tranexamic acid (TXA)Intravenous and oral, is equivalent oxytocin (OXY),intramuscularly, in reducing the blood loss in post partum period (mL) in patients at the end of pregnancy ( 37-42 w ) at low risk of post partum hemorrhage (PPH). The PPH means a blood loss equal to or greater than 500 ml after a vaginal delivery (the bleeding is defined severe if it exceeds 1000 mL). PPH is called "primary" when blood loss arose within 24 hours after birth.
Detailed Description
This trial includes three arms of treatment :
arm A (IMP1Test): TXA 500 mg/ 2 vials (1 gr) slow intravenous infusion 1ml/min within 5 minutes from the delivery(third stage af labor)
arm B (IMP2Control): OXY 5 IU/ml/ 2 vials (10 International Unit) intramuscularly within 5 minutes from the delivery (third stage af labor) The clamping of the umbilical cord will be executed immediately after birth.
The randomization 1:1 (block design), generated by the computer.
Primary outcomes: assessment of total blood loss expressed in mL:
immediately after delivery
two hours after delivery
The measurement of the overall blood loss at delivery (ml) will be performed by the graduated bag, immediately after birth.
The measurement two hours after delivery will be performed by weighing of the adsorbent material [ N.ml = N. gr indicated by the balance - dry weight of the sanitary napkin]. The overall loss in blood measured (ml) two hours of delivery will then be performed by adding the two collections.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Post Partum Haemorrhage
Keywords
TXA, PPH
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
256 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
arm A (TXA)
Arm Type
Experimental
Arm Description
2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery(third stage after labor)
Arm Title
arm B (OXY)
Arm Type
Active Comparator
Arm Description
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
Intervention Type
Drug
Intervention Name(s)
Tranexamic Acid
Other Intervention Name(s)
TXA
Intervention Description
2 vials ( =1 gram) of Tranexamic Acid slow intravenous infusion administered within 5 minutes from the delivery (third stage after labor)
Intervention Type
Drug
Intervention Name(s)
Oxytocin
Other Intervention Name(s)
OXY
Intervention Description
2 vials (=10 IU/International Unit) of Oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
Primary Outcome Measure Information:
Title
assessment of total blood loss expressed in mL
Description
global blood loss > 500 mL
Time Frame
immediately after delivery
Title
assessment of total blood loss expressed in mL
Description
global blood loss > 500 mL
Time Frame
two hours after delivery
Secondary Outcome Measure Information:
Title
assessment of the number of hemodynamic changes
Description
hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )
Time Frame
two hours after delivery
Title
assessment of the number of hemodynamic changes
Description
increased heart rate (number of women with Heart Rate > 60 bpm )
Time Frame
immediately after delivery
Title
assessment of the need of using additional uterotonic
Description
administration additional drug for the treatment of PPH
Time Frame
immediately after delivery
Title
assessment of the need of using additional uterotonic
Description
administration additional drug for the treatment of PPH
Time Frame
two hours after delivery
Title
assessment the need for surgical manoeuvres for the bleeding control
Description
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
Time Frame
immediately after
Title
assessment the need for surgical manoeuvres for the bleeding control
Description
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
Time Frame
two hours after
Title
assessment the need for the blood transfusions
Description
Hb <7 g/dL
Time Frame
two days after delivery
Title
evaluation of the number of cases in which the following was seen verified:
Description
nausea between delivery and discharge vomiting between birth and discharge headache between birth and discharge dyspnoea between birth and discharge Chest pain between birth and discharge endometritis after delivery (assessed by monitoring body temperature)
Time Frame
two days after delivery
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects at the end of pregnancy ( 37-42 w ) at low risk of PPH Mean by low-risk of PPH subjects without any of the following risk factors : hypertension/preeclampsia, placental abruption during pregnancy , placenta previa , tocolysis two hours before delivery, multiple pregnancy , previous PPH, obesity ( BMI > 35 ), anemia (Hb < 7 g/dL), elective caesarean section , induction of labor, retention of placental material , polyhydramnios , fever during labor, use of high doses of heparin low molecular weight.
Subjects full capacity and the willingness to give written informed consent .
Exclusion Criteria:
Subjects with preterm pregnancy (<37 weeks ) or with prolonged pregnancy ( > 42 weeks )
Subjects at the end of pregnancy ( 37 weeks - 42 weeks ) with the following risk factors for PPH (Tab1.Protocol Study, vers.2.0 of 07/05/2016)
multiple pregnancy
History of thromboembolic disease or high incidence of thromboembolic events in family history ( patients at high risk of thrombophilia )
Patients with Long - QT syndrome or who are taking drugs that cause QT prolongation
Intrauterine fetal Death
Epilepsy
Autoimmune disease Tab1 medical history :
Placental abruption during pregnancy
Placenta previa
Hypertension / preeclampsia
Previous PPH
Polyhydramnios
Obesity ( BMI > 35 )
Anemia ( < 7 g / dL )
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH
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