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Suivi de grossesse à distance pour améliorer l'accès (REACTIVE)

19 octobre 2026 mis à jour par: Samuel Parry, MD, University of Pennsylvania

Surveillance à distance de la grossesse pour améliorer l'accès : l'essai REACTIVE

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.

Aperçu de l'étude

Statut

Complété

Les conditions

Type d'étude

Interventionnel

Inscription (Réel)

400

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Pennsylvania
      • Philadelphia, Pennsylvania, États-Unis, 19104
        • University of Pennsylvania

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Femelle

La description

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

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Diagnostique
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: NST à distance

INVU monitoring belt used for remote NSTs

Comparateur actif: NST en clinique - Norme de soins

In-clinic NSTs - standard of care

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Fetal Testing Completion Rate
Délai: 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
Délai: 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.

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Fetal Monitoring Outcomes: Number of Visits to the Antenatal Testing Unit
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: time of delivery

gestational age at time of delivery

time of delivery
Obstetrics Outcomes: Number of Participants With Preterm Delivery
Délai: time of delivery

preterm delivery is defined as less than 37 weeks gestational age

time of delivery
Obstetrics Outcomes: Mode of Delivery
Délai: time of delivery

categorized as vaginal or cesarean

time of delivery
Obstetrics Outcomes: Number of Participants With an Indication for Labor Induction
Délai: 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
Délai: 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
Délai: 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
Délai: time of delivery
time of delivery
Obstetrics Outcomes: Apgar Scores
Délai: 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
Délai: 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
Délai: from delivery to 6 weeks post-delivery
from delivery to 6 weeks post-delivery
Obstetrics Outcomes: Maternal Length of Hospital Stay
Délai: 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
Délai: Birth hospitalization

Length of neonatal hospitalization from birth through hospital discharge.

Birth hospitalization
Cost-effectiveness Outcomes: Productivity Loss Due to Antenatal Testing and Monitoring
Délai: 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
Délai: 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
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

25 mai 2023

Achèvement primaire (Réel)

26 septembre 2025

Achèvement de l'étude (Réel)

26 septembre 2025

Dates d'inscription aux études

Première soumission

27 avril 2023

Première soumission répondant aux critères de contrôle qualité

27 avril 2023

Première publication (Réel)

8 mai 2023

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

12 novembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

19 octobre 2026

Dernière vérification

1 octobre 2026

Plus d'information

Termes liés à cette étude

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Oui

produit fabriqué et exporté des États-Unis.

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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