Clinical Trial: Revealed Versus Concealed Cerebroplacental Ratio

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Revealed Versus Concealed Criteria for Placental Insufficiency in Unselected Obstetric Population in Late Pregnancy: a Multicenter Randomized Controlled Trial

Brief Summary: The purpose of this study is to evaluate the role of an integrated strategy at selecting fetuses for delivery at term based on a combination of fetal biometry and cerebroplacental ratio (CPR) to reduce stillbirth rate and adverse perinatal outcome.

Detailed Summary:

This is a multicenter, open-label randomized trial with groups in parallel. Singleton pregnancies are recruited after routine second trimester scan (19+0 to 22+6 weeks of gestation) and randomly allocated at that moment to revealed or concealed strategy. A routine scan will be booked at 36-37 weeks. For a reduction of the stillbirth rate of 3‰ (from 5‰ to 2‰), assuming a type I error of 5% and aiming for a power of 80% a total of 11,582 subjects (5791 per arm) were projected. The participating centers sum up 12,000 deliveries a year. It is not possible to blind participants, obstetricians, or outcome assessors to the study group.

General hypothesis: A proportion of fetuses with "normal" growth as per current standards have placental insufficiency and restriction of their growth potential. These fetuses exhibit biophysical changes expressed by abnormal cerebroplacental ratio. A combination of this marker with fetal biometry for the detection of fetuses affected by fetal growth restriction could identify a group of babies on which labor induction once term is reached may prevent the occurrence of adverse outcomes.

Specific hypothesis

  • The cerebroplacental ratio has predictive value in late pregnancy for placental insufficiency.
  • The cerebroplacental ratio could improve the effectiveness of late pregnancy screening for the prediction placental insufficiency-related complications.

Sponsor: Hospital Clinic of Barcelona

Current Primary Outcome: Stillbirth [ Time Frame: between 37 and 42 weeks of pregnancy ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Adverse perinatal outcome [ Time Frame: Up to 28 days after delivery ]
  • Fetal Growth Restriction Detection [ Time Frame: 3 years ]


Original Secondary Outcome: Same as current

Information By: Hospital Clinic of Barcelona

Dates:
Date Received: August 1, 2016
Date Started: May 2016
Date Completion: January 2019
Last Updated: September 15, 2016
Last Verified: September 2016