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

10 november 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Beräknad)

1000

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Kvinna

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiv: PROSPECTIVE

Kohorter och interventioner

Grupp / Kohort
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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Sensitivity of First-Trimester Ultrasound for Detecting Velamentous Cord Insertion
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Percentage of Participants with an Indeterminate Initial Placental Cord-Insertion Assessment
Tidsram: Baseline

Proportion of participants with an indeterminate initial placental cord-insertion classification and documented reasons for indeterminate assessment, if any
Baseline
Neonatal Birth Weight
Tidsram: At delivery

Birth weight recorded at delivery, and local gestational age specific centiles where available
At delivery
Gestational age at delivery
Tidsram: At delivery

Gestational age in completed weeks at delivery
At delivery
Mode of delivery
Tidsram: At delivery

Mode of delivery recorded from maternity records
At delivery
Neonatal Apgar Scores at 1 and 5 Minutes After Birth
Tidsram: 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
Tidsram: At delivery episode

Admission to a neonatal intensive care unit
At delivery episode

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Hypertensive disorders of pregnancy
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Hospital Authority, Hong Kong

Utredare

  • Huvudutredare: Linus Lee, Hospital Authority

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 november 2026

Primärt slutförande (Beräknad)

1 juni 2028

Avslutad studie (Beräknad)

1 juni 2028

Studieregistreringsdatum

Först inskickad

23 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

10 november 2026

Första postat (Faktisk)

13 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

13 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Andra studie-ID-nummer

  • CIRB-2026-562-1

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

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.

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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