- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00143039
Amniotic Fluid Tandem Mass Spectrometry for Pregnancies Complicated by NIH and Severe Symmetrical IUGR (TandemMS)
Amniotic Fluid Tandem Mass Spectrometry for Pregnancies Complicated by Nonimmune Hydrops and Severe Symmetrical Intrauterine Growth Restriction-A Multicenter Prospective Pilot Cohort Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Nonimmune hydrops (NIH) and severe symmetrical intrauterine growth restriction (IUGR) represent two obstetrical circumstances that occur with relative frequency yet often escape adequate etiology assessment and diagnosis prior to and after birth. Both of these conditions have high perinatal and neonatal mortality rates. While antepartum ultrasound and amniotic fluid evaluations of fetal karyotype and viral DNA studies diagnose some etiologies for NIH and severe symmetrical IUGR, large percentages of NIH (30-40%) and IUGR (20-30%) cases are attributed to idiopathic causes. Because of this uncertainty in diagnosis, many cases are subjected to prolonged antepartum hospitalization with intensive fetal monitoring and urgent delivery by Cesarean section for non-reassuring fetal status, only to succumb to a neonatal demise in the nursery. A small percentage (1-2%) of these cases are found to be due to inborn errors of metabolism by neonatal and/or postmortem evaluation; however, when combined together, greater than 50% of NIH and IUGR cases have no identifiable etiology. Therefore, any new test that may make a diagnosis for NIH or severe symmetrical IUGR prior to delivery would be extremely important to the management of both the mother and the infant. Tandem mass spectrometry for inborn errors of metabolism may represent a new tool for assessing, identifying, and treating currently unexplained cases of NIH and severe symmetrical IUGR.
This is a prospective pilot cohort study of all pregnancies complicated by NIH and severe symmetrical IUGR within the Pediatrix-Obstetrix network. This network encompasses several perinatal sites throughout the United States with corresponding neonatal intensive care units utilizing a computerized patient database (RDS). The objective of this study is to prospectively evaluate amniotic fluid of pregnancies complicated by NIH and severe symmetrical IUGR by a method called tandem mass spectrometry for inborn errors of metabolism.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Arizona
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Phoenix, Arizona, United States, 85006
- Banner Good Sammaritan Hospital
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Phoenix, Arizona, United States, 85202
- Banner Desert Samaritan Hospital
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California
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Laguna Hills, California, United States, 92653
- Saddleback Memorial Medical Center
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Long Beach, California, United States, 90801-1428
- Long Beach Memorial Medical Center
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San Jose, California, United States, 95124
- Good Samaritan Hospital
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Colorado
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Denver, Colorado, United States, 80110
- Swedish Medical Center
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Denver, Colorado, United States, 80218
- Presbyterian/St Luke's Hospital
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Georgia
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Decatur, Georgia, United States, 30033
- Dekalb Medical Center
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Riverdale, Georgia, United States, 30274
- Southern Regional Medical Center
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Texas
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Fort Worth, Texas, United States, 76104
- Harris Methodist Fort Worth Hospital
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Washington
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Seattle, Washington, United States, 98122-4307
- Swedish Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
NIH Inclusion Criteria:
- Singleton gestation
- 18 years of age or older
- Excess extracellular fluid in at least two fetal sites as noted by ultrasound: abdomen (ascites), the chest (pleural and pericardial effusions), the skin (edema > 5mm), the amniotic cavity (polyhydramnios), and the placenta (thickening > 6cm)
- NIH diagnosis > 15w0d gestation
- Diagnostic amniocentesis performed at > 15w0d gestation
NIH Exclusion Criteria:
- Immune-mediated hydrops fetalis as diagnosed by maternal red cell antigens and fetal anemia suspected by middle cerebral artery doppler ultrasound and/or confirmed by percutaneous umbilical blood sampling
- Structural anomaly identified by ultrasound
- Chromosomal aneuploidy
- Multiple gestations
IUGR Inclusion Criteria:
- Singleton gestation
- 18 years of age or older
- Severe symmetrical IUGR defined as a > 3 week lag of all fetal ultrasound measurements (biparietal diameter, head circumference, abdominal circumference, and femur length)
- IUGR diagnosis between 24-32 weeks gestation
- Diagnostic amniocentesis performed prior to 32 weeks gestation
IUGR Exclusion Criteria:
- Asymmetrical IUGR
- Structural anomaly identified by ultrasound
- Chromosomal aneuploidy
- Multiple gestations
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
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NIH/SSIUGR fetuses
Group 1 includes pregnancies complicated by a fetus with either Non-Immune Hydrops or Severe Symmetrical IUGR.
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Tandem MS spectrometry test will be done on all maternal blood, amniotic fluid and newborn blood samples for both groups.
Other Names:
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Control-Normal fetus
Group 2 includes all normally appearing fetuses on U/S who will be having a diagnostic amniocentesis as part of their routine care.
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Tandem MS spectrometry test will be done on all maternal blood, amniotic fluid and newborn blood samples for both groups.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Will assess whether amniotic fluid tandem mass spectrometry results are valid when compared to neonatal blood samples for normal pregnancies and those pregnancies complicated by NIH and severe symmetrical IUGR.
Time Frame: comparrison down with in 2 days of life.
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Will assess whether amniotic fluid tandem mass spectrometry results are valid when compared to neonatal blood samples for normal pregnancies and those pregnancies complicated by NIH and severe symmetrical IUGR.
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comparrison down with in 2 days of life.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of Neonatal Complications
Time Frame: during the neonatal period
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Will include neonatal complications in pregnancies complicated by NIH and severe symmetrical IUGR.
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during the neonatal period
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Karrie Francois, MD, Pediatrix-Obstetrix Medical Group, Inc.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- OBX 0005.3
- Tandem MS - 0005.3
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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