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Transvaginal Ultrasound Cervical Length Screening in Singleton Pregnancy With Prior Spontaneous Preterm Birth

Primary Purpose

Preterm Birth

Status
Unknown status
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
Transvaginal ultrasound cervical length screening
Sponsored by
Federico II University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Preterm Birth

Eligibility Criteria

18 Years - 50 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • 18-50 years of age
  • Singleton gestations
  • Women with prior spontaneous preterm birth, defined as spontaneous preterm delivery 16 0/7 - 36 6/7 weeks

Exclusion Criteria:

  • multiple gestation
  • Ruptured membranes or fetal structural or chromosomal abnormality at the time of randomization
  • Ballooning of membranes outside the cervix into the vagina at the time of randomization
  • Labor or cerclage in situ at the time of randomization

Sites / Locations

  • Gabriele SacconeRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

TVU CL screening

No TVU CL screening

Arm Description

TVU CL screening: serial TVU CL scan from 16 0/7 to 24 6/7 every week, for a total of nine scans Vaginal progesterone 200mg suppository daily from 14 0/7 to 20 6/7 weeks for the history of prior spontaneous preterm delivery

no screening Vaginal progesterone 200mg suppository daily from 14 0/7 to 20 6/7 weeks for the history of prior spontaneous preterm delivery

Outcomes

Primary Outcome Measures

Preterm delivery

Secondary Outcome Measures

Gestational age at delivery
preterm birth rates
Birth weight
Low birth weight
Birth weight <2500g
Neonatal death
Composite adverse neonatal outcome
Includes necrotizing enterocolitis, intraventricular hemorrhage (grade 3 or higher), respiratory distress syndrome, bronchopulmonary dysplasia (BPD), retinopathy, blood-culture proven sepsis and neonatal death
Admission to neonatal intensive care unit

Full Information

First Posted
October 3, 2016
Last Updated
February 20, 2020
Sponsor
Federico II University
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1. Study Identification

Unique Protocol Identification Number
NCT02923973
Brief Title
Transvaginal Ultrasound Cervical Length Screening in Singleton Pregnancy With Prior Spontaneous Preterm Birth
Official Title
Transvaginal Ultrasound Cervical Length Screening in Singleton Pregnancy With Prior Spontaneous Preterm Birth
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 1, 2018 (Actual)
Primary Completion Date
December 1, 2021 (Anticipated)
Study Completion Date
March 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Federico II University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Preterm birth (PTB) is the major cause of perinatal morbidity and mortality. Worldwide, about 15 million babies are born too soon every year, causing 1.1 million deaths, as well as short- and long-term disability in countless survivors. Few prognostic tests are available to predict PTB. A short transvaginal ultrasound cervical length (TVU CL) has been shown to be a good predictor of PTB.Different strategies have been adopted for prevention of PTB. The evidence supports the use of vaginal progesterone in singleton pregnancies with short cervix, while cervical cerclage seems to be beneficial only in the subgroup of singleton gestations with both prior spontaneous PTB and TVU CL ≤25mm, and not in singletons without prior PTB, nor in multiple gestations. However, so far there are no level-1 data on the efficacy of TVU CL screening neither in low risk nor in high risk pregnancy Thus, the investigators aim to assess the efficacy of a policy of TVU CL screening in singleton pregnancy with prior spontaneous PTB

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Preterm Birth

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
500 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TVU CL screening
Arm Type
Experimental
Arm Description
TVU CL screening: serial TVU CL scan from 16 0/7 to 24 6/7 every week, for a total of nine scans Vaginal progesterone 200mg suppository daily from 14 0/7 to 20 6/7 weeks for the history of prior spontaneous preterm delivery
Arm Title
No TVU CL screening
Arm Type
No Intervention
Arm Description
no screening Vaginal progesterone 200mg suppository daily from 14 0/7 to 20 6/7 weeks for the history of prior spontaneous preterm delivery
Intervention Type
Other
Intervention Name(s)
Transvaginal ultrasound cervical length screening
Intervention Description
Serial transvaginal ultrasound cervical length scan every week from 16 to 24 weeks
Primary Outcome Measure Information:
Title
Preterm delivery
Time Frame
Less than 37 weeks gestation
Secondary Outcome Measure Information:
Title
Gestational age at delivery
Time Frame
Time of delivery
Title
preterm birth rates
Time Frame
Less than 24, 28, 34 weeks gestation
Title
Birth weight
Time Frame
Time of delivery
Title
Low birth weight
Description
Birth weight <2500g
Time Frame
Time of delivery
Title
Neonatal death
Time Frame
Between birth and 28 days of age
Title
Composite adverse neonatal outcome
Description
Includes necrotizing enterocolitis, intraventricular hemorrhage (grade 3 or higher), respiratory distress syndrome, bronchopulmonary dysplasia (BPD), retinopathy, blood-culture proven sepsis and neonatal death
Time Frame
Between birth and 28 days of age
Title
Admission to neonatal intensive care unit
Time Frame
Between birth and 28 days of age

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: 18-50 years of age Singleton gestations Women with prior spontaneous preterm birth, defined as spontaneous preterm delivery 16 0/7 - 36 6/7 weeks Exclusion Criteria: multiple gestation Ruptured membranes or fetal structural or chromosomal abnormality at the time of randomization Ballooning of membranes outside the cervix into the vagina at the time of randomization Labor or cerclage in situ at the time of randomization
Facility Information:
Facility Name
Gabriele Saccone
City
Naples
ZIP/Postal Code
80100
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gabriele Saccone
Phone
0817461111
Email
gabriele.saccone.1990@gmail.com

12. IPD Sharing Statement

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Transvaginal Ultrasound Cervical Length Screening in Singleton Pregnancy With Prior Spontaneous Preterm Birth

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