早孕胎盘超声研究 (First PLUS)
孕早期胎盘超声研究(First PLUS):一项观察性队列研究,用于评估 OxNNet 工具包预测不良妊娠结果的临床效用。
研究概览
详细说明
First PLUS 研究是一项单中心、前瞻性、观察性研究,从哈里斯出生权利中心招募了 4000 名妇女,该中心为所有将前往国王学院医院 NHS 信托基金会接受妊娠护理的妇女提供超声波扫描。
本研究旨在开发一种工具,以提供可靠的胎盘大小测量并估计妊娠头三个月胎盘内的血流量。 这些指标希望开发出一种胎儿生长受限 (FGR) 的筛查工具,这种情况下婴儿无法充分发挥其潜力并可能导致不良妊娠结局,并且是死产的最常见原因。 通过将怀孕分层为高风险、允许女性接受额外监测并将临床医生资源限制给最需要的人,可能会减少这种破坏性后果。 死产也是一种严重的不良妊娠结果,NHS England 希望将其作为其长期计划的一部分来降低发生率。
年龄在 18 岁或以上、在怀孕 11-14 周期间参加妊娠早期扫描的女性,如果怀孕成功且婴儿不超过一个且在扫描期间未发现重大缺陷,则有资格参加。
该研究将进行超过 24 个月,参与者将接受一次研究访问,其中将记录他们的人口统计数据和常规病史,将在常规扫描的同时进行额外的研究超声扫描,并从样本中抽取血液作为常规护理将用于评估胎盘生长因子 (PlGF) 的水平。 然后将通过他们的怀孕记录(远程跟进)对参与者进行跟进,直到他们完成怀孕,并记录他们的怀孕结果。
研究类型
注册 (实际的)
联系人和位置
学习地点
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London、英国、SE5 9RS
- King's College Hospital NHS, Fetal Medicine Foundation
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
取样方法
研究人群
描述
纳入标准:
- 孕
- 年满 18 岁或以上
- 在怀孕 11+0 和 13+6 周之间进行早孕合并测试筛查
- 参与者愿意并且能够对参与调查给予知情同意。
- 能够理解书面或口头英语,并能够使用翻译方法。
- 研究者认为,参与者没有风险或压力,也没有限制他们参与研究活动的能力。
排除标准:
- 扫描时发现多胎妊娠(不止一个活胎儿)的参与者
- 在扫描中发现无法存活的妊娠的参与者(未检测到心跳)
- 在 11+0 至 13+6 周扫描期间发现有重大缺陷的妊娠
- 任何随后因产前或产后检测发现染色体异常的妊娠
学习计划
研究是如何设计的?
设计细节
- 观测模型:队列
- 时间观点:预期
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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胎儿生长受限 (FGR)
大体时间:24个月
|
胎儿生长受限 (FGR) 根据 ISUOG Delphi 诊断 FGR 共识指南在分娩时定义。
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24个月
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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小于胎龄儿 (GSA)
大体时间:24个月
|
如果在交付时基于人口的百分位数小于 10 个百分位数或自定义百分位数小于 10 个百分位数,则定义为。
|
24个月
|
|
先兆子痫(有或没有严重特征)
大体时间:24个月
|
ACOG 妊娠期高血压疾病指南定义:
|
24个月
|
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妊娠高血压(PIH)
大体时间:24个月
|
ACOG 妊娠期高血压疾病指南定义:
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24个月
|
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溶血、肝酶升高和血小板减少 (HELLP) 综合征
大体时间:24个月
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ACOG 妊娠期高血压疾病指南定义:
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24个月
|
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子痫
大体时间:24个月
|
由 ACOG 妊娠期高血压疾病指南定义 (22)
|
24个月
|
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妊娠糖尿病
大体时间:24个月
|
定义为摄入 75g 口服葡萄糖后空腹血糖水平≥5.6 毫摩尔/升和/或 2 小时血糖水平≥7.8 毫摩尔/升。
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24个月
|
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早产
大体时间:24个月
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出生 ≥24+0 周 <37+0 周
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24个月
|
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流产
大体时间:24个月
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早孕期超声扫描时为活胎儿,但随后在子宫内胎儿死亡或分娩 <24+0 周
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24个月
|
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死胎
大体时间:24个月
|
妊娠 ≥ 24+0 周出生时无生命迹象的婴儿
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24个月
|
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新生儿死亡
大体时间:24个月
|
出生时活着但在出生后 28 天内死亡的婴儿
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24个月
|
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新生儿发病率
大体时间:24个月
|
|
24个月
|
合作者和调查者
赞助
调查人员
- 首席研究员:Kypros Nicolaides, BSc, MMBS、Fetal Medicine Foundation
出版物和有用的链接
一般刊物
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- Plasencia W, Akolekar R, Dagklis T, Veduta A, Nicolaides KH. Placental volume at 11-13 weeks' gestation in the prediction of birth weight percentile. Fetal Diagn Ther. 2011;30(1):23-8. doi: 10.1159/000324318. Epub 2011 Jun 23.
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- RONNEBERGER O, FISCHER P, BROX T. U-Net: Convolutional Networks for Biomedical Image Segmentation. International Conference on Medical Image Computing and Computer-Assisted Intervention 2015;Springer:234-41.
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- Huang SF, Chang RF, Moon WK, Lee YH, Chen DR, Suri JS. Analysis of tumor vascularity using three-dimensional power Doppler ultrasound images. IEEE Trans Med Imaging. 2008 Mar;27(3):320-30. doi: 10.1109/TMI.2007.904665.
- LEE TC, KASHYAP RL, CHU CN. Building Skeleton Models via 3-D Medial Surface Axis Thinning Algorithms. CVGIP: Graphical Models and Image Processing 1994;56:462-78
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研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (估计的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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