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First-Trimester Ultrasound Assessment of Velamentous Cord Insertion (1T-VCI)

10. november 2026 opdateret af: Linus Lee, Hospital Authority, Hong Kong

Prospective Study of First-Trimester Ultrasound Direct Visualisation of Velamentous Cord Insertion

The goal of this observational study is to learn whether a short ultrasound assessment during the routine first-trimester pregnancy scan can identify velamentous cord insertion, an abnormal location where the umbilical cord joins the placenta. The study will include pregnant participants aged 18 years or older with a singleton pregnancy who attend first-trimester combined screening between 11+0 and 13+6 weeks of pregnancy.

The main questions it aims to answer are:

  • How often can the placental cord-insertion site be successfully classified within a 3-minute assessment?
  • How accurately does first-trimester ultrasound identify velamentous cord insertion compared with examination of the placenta after delivery?

Participants will:

  • Attend their usual first-trimester ultrasound examination.
  • Have an additional transabdominal ultrasound assessment of the placental cord-insertion site after the routine scan, taking no more than 3 minutes.
  • Allow the study team to review relevant pregnancy and birth records.
  • If they deliver at the study hospital, allow examination of the placenta after delivery as part of the study reference standard.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Detaljeret beskrivelse

Participants with singleton pregnancies attending first-trimester combined screening between 11+0 and 13+6 weeks will be invited to participate. The research-specific placental cord-insertion assessment will be performed after completion of routine clinical care and will not replace or alter standard ultrasound assessment. The insertion will be initially classified as normal, VCI, or undetermined.

VCI or undetermined examinations will undergo repeat ultrasound assessment in the same setting or within 1 week by maternal-fetal-medicine team, transvaginal ultrasound may be considered to facilitate visualization. If an abnormal insertion is confirmed, subsequent care, including repeat assessment and transvaginal ultrasound for vasa previa where clinically indicated, will follow existing practice.

For participants who deliver at the study hospital, available placentas will undergo blinded structured postnatal gross examination and standardized photographic documentation. The final postnatal placental classification, reviewed by an assessor blinded to antenatal ultrasound classifications and neonatal outcome, will serve as the reference standard for the primary diagnostic-accuracy analysis.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

1000

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

      • Hong Kong, Hong Kong
        • Pamela Youde Nethersole Eastern Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Kvinde

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

The study population comprises pregnant participants aged 18 years or older with singleton pregnancies who attend routine first-trimester combined screening at Pamela Youde Nethersole Eastern Hospital Hong Kong between 11+0 and 13+6 weeks of gestation. Participants must have capacity to provide written informed consent. Individuals with multiple pregnancies and those who decline or withdraw consent will not be included. All enrolled participants will undergo the same focused, research-specific transabdominal ultrasound assessment of the placental cord-insertion site after completion of their routine clinical screening examination.

Beskrivelse

Inclusion Criteria:

  • Pregnant participants aged 18 years or older with a singleton pregnancy
  • Attendance for first-trimester combined screening at 11+0 to 13+6 weeks
  • Capacity to provide written informed consent

Exclusion Criteria:

  • Multiple pregnancy
  • Declined or withdrawn consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Singleton pregnancies undergoing first-trimester placental cord-insertion assessment

Consenting pregnant participants aged 18 years or older with singleton pregnancies attending first-trimester combined screening at Pamela Youde Nethersole Eastern Hospital Hong Kong at 11+0 to 13+6 weeks gestation. Following routine screening, participants undergo a focused transabdominal placental cord-insertion assessment of up to 3 additional minutes, with review or repeat assessment according to the prespecified pathway where needed.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sensitivity of First-Trimester Ultrasound for Detecting Velamentous Cord Insertion
Tidsramme: Up to 7 months after the baseline assessment, at postnatal placental examination.

Sensitivity of first-trimester ultrasound for detection of velamentous cord insertion

Up to 7 months after the baseline assessment, at postnatal placental examination.
Specificity of First-Trimester Ultrasound for Detecting Velamentous Cord Insertion
Tidsramme: Up to 7 months after the baseline assessment, at postnatal placental examination.

Specificity of first-trimester ultrasound for detection of velamentous cord insertion

Up to 7 months after the baseline assessment, at postnatal placental examination.
Percentage of Participants with a Definitive Classification Within the Initial 3-Minute Ultrasound Assessment
Tidsramme: Baseline

Proportion of participants classified as either normal placental cord insertion or velamentous cord insertion within the prespecified 3-minute focused ultrasound assessment.

Baseline
Percentage of Participants with a Definitive Classification After Completion of the Assessment Pathway
Tidsramme: Up to 1 week after the baseline assessment

Proportion of participants with a final classification of either normal placental cord insertion or velamentous cord insertion after maternal-fetal-medicine review and/or repeat ultrasound assessment, where required.

Up to 1 week after the baseline assessment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Percentage of Participants with an Indeterminate Initial Placental Cord-Insertion Assessment
Tidsramme: Baseline

Proportion of participants with an indeterminate initial placental cord-insertion classification and documented reasons for indeterminate assessment, if any

Baseline
Neonatal Birth Weight
Tidsramme: At delivery

Birth weight recorded at delivery, and local gestational age specific centiles where available

At delivery
Gestational age at delivery
Tidsramme: At delivery

Gestational age in completed weeks at delivery

At delivery
Mode of delivery
Tidsramme: At delivery

Mode of delivery recorded from maternity records

At delivery
Neonatal Apgar Scores at 1 and 5 Minutes After Birth
Tidsramme: At delivery episode, 1 and 5 minutes after birth

Apgar scores assessed at 1 and 5 minutes after birth. Scores range from 0 to 10, with higher scores indicating better neonatal condition.

At delivery episode, 1 and 5 minutes after birth
NICU admission
Tidsramme: At delivery episode

Admission to a neonatal intensive care unit

At delivery episode

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Hypertensive disorders of pregnancy
Tidsramme: From baseline assessment to delivery, up to 7 months

Incidence of gestational hypertension, pre-eclampsia, or chronic hypertension with superimposed pre-eclampsia, summarized descriptively according to antenatal and postnatal placental cord-insertion status

From baseline assessment to delivery, up to 7 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Linus Lee, Hospital Authority

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. november 2026

Primær færdiggørelse (Anslået)

1. juni 2028

Studieafslutning (Anslået)

1. juni 2028

Datoer for studieregistrering

Først indsendt

23. oktober 2026

Først indsendt, der opfyldte QC-kriterier

10. november 2026

Først opslået (Faktiske)

13. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • CIRB-2026-562-1

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be shared outside the study team because the study involves potentially identifiable pregnancy, ultrasound, placental, and perinatal clinical data held under institutional data-governance and privacy requirements. De-identified aggregate data may be available in publications or on reasonable request, subject to applicable approval and requirements.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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