- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03775954
Fetal Electrophysiologic Abnormalities in High-Risk Pregnancies Associated With Fetal Demise
Fetal Electrophysiologic Abnormalities in High-risk Pregnancies Associated With Fetal Demise
Study Overview
Status
Conditions
- Sudden Infant Death
- Congenital Heart Disease
- Pregnancy Loss
- Gastroschisis
- Fetal Death
- Brugada Syndrome
- High Risk Pregnancy
- Stillbirth
- Long QT Syndrome
- Fetal Demise
- Birth Defect
- Twin Monochorionic Monoamniotic Placenta
- Twin Twin Transfusion Syndrome
- Fetal Hydrops
- Fetal Arrhythmia
- Intrauterine Fetal Death
- Fetal Cardiac Anomaly
- Fetal Cardiac Disorder
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Mara C Koffarnus, MD
- Phone Number: 414-266-4758
- Email: mkoffarn@mcw.edu
Study Contact Backup
- Name: Gretchen Eckstein
- Phone Number: 414-266-3539
- Email: geckstein@chw.org
Study Locations
-
-
Wisconsin
-
Madison, Wisconsin, United States, 53715
- Recruiting
- University of Wisconsin - Madison
-
Contact:
- Ronald T Wakai, PhD
- Email: rtwakai@wisc.edu
-
Contact:
- Gretchen Eckstein, RN, BSN
- Phone Number: 414-266-3539
- Email: geckstein@chw.org
-
Milwaukee, Wisconsin, United States, 53226
- Recruiting
- Medical College of Wisconsin
-
Contact:
- Janette F Strasburger, MD
- Phone Number: 414-266-2000
- Email: jstrasbu@mcw.edu
-
Contact:
- Gretchen C Eckstein, RN, BSN
- Phone Number: 414-266-3539 (Preferred)
- Email: geckstein@chw.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
Current pregnancy complicated by one of the five diagnostic categories
- prior unexplained Stillbirth at/after 20 weeks gestation
- fetal major congenital heart defect
- fetal hydrops
- fetal gastroschisis
- monochorionic twin pregnancy
- Subject must be 18 years of age or older
- Subject must be English speaking and must be able to read and sign the consent form in English
- Subject must be able to recline comfortably for 1-3 hours
- Subject must be willing to complete all three procedures (fMCG, fMCG, nECG) as per protocol, unless medically unable
- Subject must be willing to allow us to review her and her infants prenatal, deliver, and post-natal records to verify diagnosis, and clinical findings.
Exclusion Criteria:
- Severe claustrophobia not reduced by taking breaks, or by having the light on, or by having someone in the room with them.
- Active labor
- Acute illness
- Unable to recline comfortably with a pillow for more than 1-3 hours (assuming some breaks are provided)
- Weight over 450 lbs
An electric stimulation device (TENS unit, pacemaker, or nerve stimulator) that could produce electric or magnetic noise.
- Note that the Tristan 624 Magnetometer does not pose a risk to the subject's device, (since fMCG does not produce any energy or magnetism), but stimulators themselves can cause interference for our recordings. Some devices may still qualify, and discussion with study nurse may be useful if subject has a pacemaker or similar device.
The subject will have a single 2-3 hour fetal magnetocardiogram at approximately 20 and 27 weeks GA, and again, if medical condition allows, between 30 and 37 weeks GA, then her infant will have an ECG between 0 and 4 weeks of age. Subjects will be paid a nominal fee for their participation each time, as well as transportation reimbursement if >25 miles. For subjects traveling a long distance, the ECG may be performed locally or at home.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
1) Fetal Congenital Heart Disease
Pregnancy with major fetal congenital heart disease, after 20 weeks gestation, and as neonate following delivery.
Two fetal magnetocardiograms (fMCG) and 1 neonatal electrocardiogram (nECG) will be obtained and heart rate, rhythm, and conduction patterns will be compared.
|
Fetal Magnetocardiography (fMCG) is a new non-invasive diagnostic procedure that records tiny fetal cardiac signals similar to an Electrocardiogram or Holter monitor.
The magnetometer has FDA clearance, and does not emit magnetic, electric or other energies.
This is not an MRI.
Examples of fetal MCG's can be found in the Links.
The American Heart Association Scientific Statement on Fetal Diagnosis and Treatment (Circulation, 2014) has declared fMCG to be Class IIa for fetal heart rhythm abnormalities, meaning that benefit far exceeds risk.
As part of this study, a neonatal electrocardiogram (nECG) will be obtained for comparison after the baby is born.
|
2) History of fetal demise (Stillbirth)
Pregnancy with a history of an unexplained fetal demise (stillbirth at 20 -40 weeks gestation) during any prior pregnancy.
Two fetal magnetocardiograms (fMCG) and 1 neonatal electrocardiogram (nECG) will be obtained and heart rate, rhythm, and conduction patterns will be compared.
|
Fetal Magnetocardiography (fMCG) is a new non-invasive diagnostic procedure that records tiny fetal cardiac signals similar to an Electrocardiogram or Holter monitor.
The magnetometer has FDA clearance, and does not emit magnetic, electric or other energies.
This is not an MRI.
Examples of fetal MCG's can be found in the Links.
The American Heart Association Scientific Statement on Fetal Diagnosis and Treatment (Circulation, 2014) has declared fMCG to be Class IIa for fetal heart rhythm abnormalities, meaning that benefit far exceeds risk.
As part of this study, a neonatal electrocardiogram (nECG) will be obtained for comparison after the baby is born.
|
3) Fetal hydrops, immune or non-immune
Pregnancy with fetal hydrops, immune or non-immune, at or after 20 weeks gestation.
Two fetal magnetocardiograms (fMCG) and 1 neonatal electrocardiogram (nECG) will be obtained and heart rate, rhythm, and conduction patterns will be compared.
|
Fetal Magnetocardiography (fMCG) is a new non-invasive diagnostic procedure that records tiny fetal cardiac signals similar to an Electrocardiogram or Holter monitor.
The magnetometer has FDA clearance, and does not emit magnetic, electric or other energies.
This is not an MRI.
Examples of fetal MCG's can be found in the Links.
The American Heart Association Scientific Statement on Fetal Diagnosis and Treatment (Circulation, 2014) has declared fMCG to be Class IIa for fetal heart rhythm abnormalities, meaning that benefit far exceeds risk.
As part of this study, a neonatal electrocardiogram (nECG) will be obtained for comparison after the baby is born.
|
4) Fetal gastroschisis
Pregnancy with fetal gastroschisis, at or after 20 weeks gestation.
Two fetal magnetocardiograms (fMCG) and 1 neonatal electrocardiogram (nECG) will be obtained and heart rate, rhythm, and conduction patterns will be compared.
|
Fetal Magnetocardiography (fMCG) is a new non-invasive diagnostic procedure that records tiny fetal cardiac signals similar to an Electrocardiogram or Holter monitor.
The magnetometer has FDA clearance, and does not emit magnetic, electric or other energies.
This is not an MRI.
Examples of fetal MCG's can be found in the Links.
The American Heart Association Scientific Statement on Fetal Diagnosis and Treatment (Circulation, 2014) has declared fMCG to be Class IIa for fetal heart rhythm abnormalities, meaning that benefit far exceeds risk.
As part of this study, a neonatal electrocardiogram (nECG) will be obtained for comparison after the baby is born.
|
5) Twin pregnancy, monochorionic
Twin pregnancy, monochorionic, with or without twin-twin transfusion syndrome, at or after 20 weeks gestation.
Two fetal magnetocardiograms (fMCG) and 1 neonatal electrocardiogram (fMCG) will be obtained and heart rate, rhythm, and conduction patterns will be compared.
|
Fetal Magnetocardiography (fMCG) is a new non-invasive diagnostic procedure that records tiny fetal cardiac signals similar to an Electrocardiogram or Holter monitor.
The magnetometer has FDA clearance, and does not emit magnetic, electric or other energies.
This is not an MRI.
Examples of fetal MCG's can be found in the Links.
The American Heart Association Scientific Statement on Fetal Diagnosis and Treatment (Circulation, 2014) has declared fMCG to be Class IIa for fetal heart rhythm abnormalities, meaning that benefit far exceeds risk.
As part of this study, a neonatal electrocardiogram (nECG) will be obtained for comparison after the baby is born.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Heart rate variability using fMCG
Time Frame: Comparison of procedures at approximately 20-27 weeks gestation, at 30-37 weeks gestation, and at neonatal ECG at 0-4 weeks of age
|
To measure and compare the fMCG heart rate variability in five pregnancy conditions associated with fetal demise, to those of gestation matched normal fetuses.
|
Comparison of procedures at approximately 20-27 weeks gestation, at 30-37 weeks gestation, and at neonatal ECG at 0-4 weeks of age
|
Cardiac conduction
Time Frame: Comparison of cardiac time intervals at approximately 20-27 weeks gestation, 30-37 weeks gestation and at neonatal ECG at 0-4 weeks of age
|
To measure and compare the fMCG cardiac time intervals in five pregnancy conditions associated with fetal demise, to those of gestation matched normal fetuses and to neonatal ECGs at 0-4 weeks of age.
|
Comparison of cardiac time intervals at approximately 20-27 weeks gestation, 30-37 weeks gestation and at neonatal ECG at 0-4 weeks of age
|
Cardiac repolarization
Time Frame: Comparison of cardiac repolarization at approximately 20-27 weeks gestation, 30-37 weeks gestation and neonatal ECG at 0-4 weeks of age.
|
To measure and compare the fMCG cardiac repolarization patterns in five pregnancy conditions associated with fetal demise, to those of gestation matched normal fetuses, and to neonatal ECGs at 0-4 weeks of age.
|
Comparison of cardiac repolarization at approximately 20-27 weeks gestation, 30-37 weeks gestation and neonatal ECG at 0-4 weeks of age.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Unique "signature" electrophysiologic abnormalities
Time Frame: Comparison of findings at approximately 20-27 weeks gestation, 30-37 weeks gestation and neonatal ECG at 0-4 weeks of age
|
2a) To determine whether unique "signature" electrophysiologic abnormalities are present in any of these five maternal-fetal diseases, and 2b) to define at what trimester these develop. Understanding any unique findings could allow study of specific treatment strategies in the future. findings are first seen. |
Comparison of findings at approximately 20-27 weeks gestation, 30-37 weeks gestation and neonatal ECG at 0-4 weeks of age
|
Pregnancy outcomes
Time Frame: Comparison of findings at approximately 20-27 weeks gestation, 30-37 weeks gestation and neonatal ECG at 0-4 weeks of age
|
To correlate fMCG findings with 3a) outcomes of pregnancies (fetal demise, premature delivery, small for GA, 5 minute APGAR < 5, neonatal death) and 3b) fMCG cardiac time intervals with postnatal ECG intervals at 0-4 weeks of age.
|
Comparison of findings at approximately 20-27 weeks gestation, 30-37 weeks gestation and neonatal ECG at 0-4 weeks of age
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Janette F Strasburger, MD, Medical College of Wisconsin
Publications and helpful links
General Publications
- Donofrio MT, Moon-Grady AJ, Hornberger LK, Copel JA, Sklansky MS, Abuhamad A, Cuneo BF, Huhta JC, Jonas RA, Krishnan A, Lacey S, Lee W, Michelfelder EC Sr, Rempel GR, Silverman NH, Spray TL, Strasburger JF, Tworetzky W, Rychik J; American Heart Association Adults With Congenital Heart Disease Joint Committee of the Council on Cardiovascular Disease in the Young and Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Council on Cardiovascular and Stroke Nursing. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 2014 May 27;129(21):2183-242. doi: 10.1161/01.cir.0000437597.44550.5d. Epub 2014 Apr 24. Erratum In: Circulation. 2014 May 27;129(21):e512.
- Strasburger JF, Wakai RT. Fetal cardiac arrhythmia detection and in utero therapy. Nat Rev Cardiol. 2010 May;7(5):277-90. doi: 10.1038/nrcardio.2010.32.
- Cuneo BF, Strasburger JF, Yu S, Horigome H, Hosono T, Kandori A, Wakai RT. In utero diagnosis of long QT syndrome by magnetocardiography. Circulation. 2013 Nov 12;128(20):2183-91. doi: 10.1161/CIRCULATIONAHA.113.004840.
- Batie M, Bitant S, Strasburger JF, Shah V, Alem O, Wakai RT. Detection of Fetal Arrhythmia Using Optically-Pumped Magnetometers. JACC Clin Electrophysiol. 2018 Feb;4(2):284-287. doi: 10.1016/j.jacep.2017.08.009. No abstract available.
- Strand S, Strasburger JF, Cuneo BF, Wakai RT. Complex and Novel Arrhythmias Precede Stillbirth in Fetuses With De Novo Long QT Syndrome. Circ Arrhythm Electrophysiol. 2020 May;13(5):e008082. doi: 10.1161/CIRCEP.119.008082. Epub 2020 May 18.
- Strand S, Lutter W, Strasburger JF, Shah V, Baffa O, Wakai RT. Low-Cost Fetal Magnetocardiography: A Comparison of Superconducting Quantum Interference Device and Optically Pumped Magnetometers. J Am Heart Assoc. 2019 Aug 20;8(16):e013436. doi: 10.1161/JAHA.119.013436. Epub 2019 Aug 9.
- Wacker-Gussmann A, Strasburger JF, Wakai RT. Fetal Magnetocardiography Alters Diagnosis and Management in Fetal Congenital Heart Disease and Cardiomyopathy. JACC Clin Electrophysiol. 2022 Sep;8(9):1159-1161. doi: 10.1016/j.jacep.2022.04.012. Epub 2022 Jun 29. No abstract available.
- Wacker-Gussmann A, Strasburger JF, Wakai RT. Contribution of Fetal Magnetocardiography to Diagnosis, Risk Assessment, and Treatment of Fetal Arrhythmia. J Am Heart Assoc. 2022 Aug 2;11(15):e025224. doi: 10.1161/JAHA.121.025224. Epub 2022 Jul 29.
- Strasburger JF, Eckstein G, Butler M, Noffke P, Wacker-Gussmann A. Fetal Arrhythmia Diagnosis and Pharmacologic Management. J Clin Pharmacol. 2022 Sep;62 Suppl 1(Suppl 1):S53-S66. doi: 10.1002/jcph.2129.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Cardiovascular Diseases
- Immune System Diseases
- Disease
- Hematologic Diseases
- Infant, Newborn, Diseases
- Genetic Diseases, Inborn
- Musculoskeletal Diseases
- Pathological Conditions, Anatomical
- Hernia, Abdominal
- Anemia
- Death, Sudden
- Cardiac Conduction System Disease
- Fetal Diseases
- Pregnancy Complications
- Hemoglobinopathies
- Cardiovascular Abnormalities
- Musculoskeletal Abnormalities
- Hernia
- Erythroblastosis, Fetal
- alpha-Thalassemia
- Thalassemia
- Anemia, Neonatal
- Edema
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Heart Diseases
- Syndrome
- Death
- Infant Death
- Sudden Infant Death
- Congenital Abnormalities
- Arrhythmias, Cardiac
- Heart Defects, Congenital
- Gastroschisis
- Hydrops Fetalis
- Fetal Death
- Brugada Syndrome
- Stillbirth
- Long QT Syndrome
- Fetofetal Transfusion
Other Study ID Numbers
- PRO00031598
- R01HL143485 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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