- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02302573
Placenta Accreta : Contrast-enhanced Ultrasound Analysis in High Risk Population
Abnormally invasive placenta (AIP) is defined as an abnormal placental attachment of a part or the entire chorionic plate with penetration of chorionic villi in the myometrium and absence of the decidua basalis. This anomaly is associated with significant maternal morbidity and mortality as it may result in severe haemorrhage during the post-partum. It has been demonstrated that prenatal diagnosis of AIP is essential to reduce maternal morbidity. In a recent study of Chantraine F. et al. prenatal diagnosis of AIP leads to better outcomes, due to fewer emergency operations and less mass transfusions. Currently, the diagnosis of AIP is based on a combination of conventional B-mode ultrasound and MRI. However, prenatal diagnosis of AIP remains challenging and recent reports demonstrated it is achieved in only thirds of cases.
Contrast enhanced ultrasound (CEUS) is a non-invasive technique based on the detection by ultrasound (US) of gas-filled microbubbles used as perfusion tracers. Intravascular rheological properties of these bubbles are similar to those of red blood cells and they remain entirely within the intravascular space. Previous studies have demonstrated that microbubbles do not transfer into fetal circulation. CEUS has been used for years in many US imaging applications (e.g. liver, kidneys and breast). In obstetrics, despite not yet approved for clinical use, CEUS offers the opportunity to analyze anatomical placental landmarks, improving the contrast between placenta and myometrium. In addition, quantification parameters related to the contrast enhancement have been proposed as objective indicators to estimate blood perfusion rates in the placental intervillous space.
The main objective of this study is to provide pre-clinical evaluation of CEUS for the diagnosis of AIP and to try to determine if AIP are characterised by differences in intervillous blood rheological properties. Conventional CEUS parameters will be: rise time, peak enhancement, wash-in rate, mean transit time and wash-in area under the curve.
As this study is a pre-clinical evaluation, sample size calculation remains subjective and imprecise. For this reason, a sample size of 100 pregnant women to be included in this prospective study has been decided.
The potential impact of this study will be to propose a more reliable tool with both improved sensibility and specificity compared to the combination US/MRI and therefore to reduce the maternal worldwide burden of AIP.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Tours, France, 37044
- University Hospital of Tours
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¨Poitiers, France, 86000
- CHU La Millétrie
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Pregnant patient having any of the following two conditions:
- Scar uterus (previous cesarean) with placenta previa partly or wholly on the uterine scar
- Placenta praevia and patient aged over 35 years
- Term > 34 weeks of amenorrhea
- More than 18 years old
- Inform consent form signed
- affiliated to medical insurrance
Exclusion Criteria:
- Inability to understand information
- Contraindications to the contrast medium Sonovue:
Hypersensitivity to hexafluorinated sulphur or any other components of Sonovue
- Recent acute coronary syndrome (within 6 months before the intervention)
- Unstable ischemic heart disease (myocardial infarction being formed or evolving, typical angina of rest in the previous month)
- Significant worsening of cardiac symptoms between the pre anaesthesia consultation and intervention
- Recent intervention (less than 6 months) on coronary arteries or other factor suggesting clinical instability (changes in ECG, changes in clinical or biological parameters)
- Acute heart failure or heart failure stage III or IV
- Severe arrhythmias
- Right-left shunt
- Acute endocarditis
- Valve prothesis
- Severe pulmonary hypertension (pulmonary artery pressure > 90mmHg)
- Systemic hypertension uncontrolled
- Respiratory distress syndrome
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: placenta accreta
contast-enhanced ultrasound with sonovue
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contast-enhanced ultrasound with sonovue
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Conventional contrast enhanced ultrasound parameters for diagnosing placenta accreta
Time Frame: up to 9 months after consent
|
up to 9 months after consent
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
depth of infiltration placenta measured by CEUS
Time Frame: up to 9 months after consent
|
up to 9 months after consent
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Franck Perrotin, MD, University Hospital of Tours
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- PHRI08-FP : Placenta Accreta
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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