- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT05847790
Raskauden etäseuranta pääsyn parantamiseen (REACTIVE)
Raskauden etäseuranta pääsyn parantamiseen: REACTIVE-kokeilu
The goal of this clinical trial is to determine the effectiveness of remote nonstress test (NST) compared to in-clinic NSTs in improving fetal testing completion rates. Participants will be randomized to either in-clinic NSTs or use of an FDA-approved remote monitoring belt for their pregnancy monitoring.
Tutkimuksen yleiskatsaus
Tila
Ehdot
Interventio / Hoito
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Yhdysvallat, 19104
- University of Pennsylvania
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Lapsi
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Singleton pregnancy
- Gestational age between 30 weeks 0 days and 35 weeks 6 days
- Pregnant patients who have clinical indication for fetal surveillance with NSTs (based on UPHS Health System clinical guidelines for antenatal monitoring)
- Able to provide written consent
- English speaking
Exclusion Criteria:
- Multiple gestations
- Maternal pre-gravid BMI greater than 45kg/m2
- Presence of an implanted pacemaker or defibrillator
- Active abdominal skin infection
- A known amniotic fluid index (AFI) less than 5cm or greater than 25cm on the most recent ultrasound (if available) prior to randomization
- Delivery is planned within 2 weeks of potential randomization
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Diagnostiikka
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: Etä NST
|
INVU monitoring belt used for remote NSTs |
|
Active Comparator: Klinikalla NST - Hoidon standardi
|
In-clinic NSTs - standard of care |
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Fetal Testing Completion Rate
Aikaikkuna: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Percentage of recommended antenatal testing sessions successfully completed, defined as a clinically interpreted test performed. Calculated for each participant as: number of NST visits completed divided by number of NST visits expected × 100. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
|
Fetal Testing Completion Rate in Black Versus Non-Black Subjects
Aikaikkuna: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Comparison between Black and non-Black subjects' percentage of recommended antenatal testing sessions that were successfully completed as defined as a clinically interpreted test was performed. Calculated as the number of NST visits completed divided by the number of NST visits expected per participant × 100. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Fetal Monitoring Outcomes: Number of Visits to the Antenatal Testing Unit
Aikaikkuna: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Count of visits to the office for in-person monitoring |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
|
Fetal Monitoring Outcomes: Percentage of Non-Stress Test Sessions Requiring Provider-Recommended Prolonged Monitoring
Aikaikkuna: From randomization until delivery.
|
For each participant, the percentage of all NST sessions requiring prolonged monitoring (>40 minutes) was calculated. The median participant-level percentage is reported. |
From randomization until delivery.
|
|
Fetal Monitoring Outcomes: Average Duration of Non-Stress Test Monitoring Sessions
Aikaikkuna: From randomization until delivery.
|
Mean duration of NST monitoring sessions across all NSTs completed by each participant from randomization to delivery. Participant-level means were calculated and summarized by study arm. |
From randomization until delivery.
|
|
Fetal Monitoring Outcomes: Non-reactive NST Rate
Aikaikkuna: From randomization until delivery
|
Percentage of NSTs that were non-reactive among all NSTs completed for each participant. |
From randomization until delivery
|
|
Fetal Monitoring Outcomes: Percentage of NSTs Resulting in Biophysical Profile Evaluation
Aikaikkuna: From randomization until delivery.
|
Percentage of completed NSTs followed by biophysical profile assessment. |
From randomization until delivery.
|
|
Fetal Monitoring Outcomes: Number of Participants With ≥1 Obstetrical Triage Visit
Aikaikkuna: From randomization to delivery
|
Number of Participants With ≥1 Obstetrical Triage Visit |
From randomization to delivery
|
|
Fetal Monitoring Outcomes: Number of Participants Who Had Any Triage Visit Directly Related to a Fetal Monitoring Visit
Aikaikkuna: From randomization to delivery
|
Number of participants who underwent at least one obstetrical triage evaluation directly related to a fetal monitoring visit, during the study period from randomization until delivery. |
From randomization to delivery
|
|
Fetal Monitoring Outcomes: Number of Participants Recommended for Delivery Based on Findings on Fetal Monitoring Result
Aikaikkuna: From randomization to delivery
|
Count of the number of subjects in each arm who receive a recommendation for delivery based on the findings of the fetal monitoring results. |
From randomization to delivery
|
|
Fetal Monitoring Outcomes: Percentage of NSTs Not Completed Within the Prescribed Window
Aikaikkuna: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Percentage of NSTs which occur outside of prescribed window, for example, if a weekly testing regimen is prescribed, an appointment 8 or more days following the last one would count as 1 missed calendar window. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
|
Obstetrics Outcomes: Gestational Age at Delivery
Aikaikkuna: time of delivery
|
gestational age at time of delivery |
time of delivery
|
|
Obstetrics Outcomes: Number of Participants With Preterm Delivery
Aikaikkuna: time of delivery
|
preterm delivery is defined as less than 37 weeks gestational age |
time of delivery
|
|
Obstetrics Outcomes: Mode of Delivery
Aikaikkuna: time of delivery
|
categorized as vaginal or cesarean |
time of delivery
|
|
Obstetrics Outcomes: Number of Participants With an Indication for Labor Induction
Aikaikkuna: time of labor induction
|
in subjects who have labor induction, indication for inducing labor |
time of labor induction
|
|
Obstetrics Outcomes: Number of Participants With an Indication for Cesarean Section
Aikaikkuna: time of delivery
|
in subjects who have a cesarean section delivery, indication for cesarean section |
time of delivery
|
|
Obstetrics Outcomes: Number of Participants With Composite Neonatal Morbidity
Aikaikkuna: from delivery to 6 weeks post-delivery
|
Number of participants whose neonate experienced at least one component of the composite neonatal morbidity outcome, defined as severe respiratory distress, neonatal resuscitation outside the delivery room, or neonatal death. |
from delivery to 6 weeks post-delivery
|
|
Obstetrics Outcomes: Neonatal Cord Blood pH
Aikaikkuna: time of delivery
|
time of delivery
|
|
|
Obstetrics Outcomes: Apgar Scores
Aikaikkuna: one and five minutes after delivery
|
Apgar score at 1 and 5 minutes after delivery. Scores range from 0 to 10, with higher scores indicating better neonatal condition |
one and five minutes after delivery
|
|
Obstetrics Outcomes: Number of Participants With an Admission to the Neonatal Intensive Care Unit
Aikaikkuna: from delivery to 6 weeks post-delivery
|
from delivery to 6 weeks post-delivery
|
|
|
Obstetrics Outcomes: Number of Participants Who Had an Admission to the Neonatal Intensive Care Unit for Greater Than 48 Hours
Aikaikkuna: from delivery to 6 weeks post-delivery
|
from delivery to 6 weeks post-delivery
|
|
|
Obstetrics Outcomes: Maternal Length of Hospital Stay
Aikaikkuna: Delivery hospitalization
|
Length of maternal hospitalization associated with the delivery admission, measured from hospital admission for delivery through maternal discharge. |
Delivery hospitalization
|
|
Obstetrics Outcomes: Neonatal Length of Hospital Stay
Aikaikkuna: Birth hospitalization
|
Length of neonatal hospitalization from birth through hospital discharge. |
Birth hospitalization
|
|
Cost-effectiveness Outcomes: Productivity Loss Due to Antenatal Testing and Monitoring
Aikaikkuna: From randomization until delivery (approximately 10 weeks on average)
|
Productivity loss was assessed by summing the number of days of work missed reported by participants across the two study productivity assessments. The reported value represents the total number of work days missed during the study period for each participant. |
From randomization until delivery (approximately 10 weeks on average)
|
|
Cost-effectiveness Outcomes: Total Societal Perspective Cost
Aikaikkuna: Randomization through delivery
|
Total societal perspective cost per participant, calculated as the sum of direct healthcare costs, informal healthcare costs, and productivity costs incurred from randomization through delivery. Costs are reported in U.S. dollars (USD). The societal perspective includes costs related to antenatal testing, delivery hospitalization, neonatal care, triage visits, antepartum admissions, productivity losses, caregiving, and transportation. |
Randomization through delivery
|
|
Implementation Outcomes: Theory-informed Acceptability Questionnaire
Aikaikkuna: at time of delivery
|
Participant acceptability of the assigned fetal monitoring strategy was assessed using an 8-item Theory-Informed Acceptability Questionnaire (TFA). Total scores range from 8 to 40, with higher scores indicating greater acceptability of the monitoring approach. |
at time of delivery
|
Yhteistyökumppanit ja tutkijat
Sponsori
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- 852291
Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
Yhdysvalloissa valmistettu ja sieltä viety tuote
Nämä tiedot haettiin suoraan verkkosivustolta clinicaltrials.gov ilman muutoksia. Jos sinulla on pyyntöjä muuttaa, poistaa tai päivittää tutkimustietojasi, ota yhteyttä register@clinicaltrials.gov. Heti kun muutos on otettu käyttöön osoitteessa clinicaltrials.gov, se päivitetään automaattisesti myös verkkosivustollemme .