Wireless Physiologic Monitoring in Postpartum Women
- Conditions
- Maternal Death During ChildbirthPregnancy Complications
- Registration Number
- NCT04060667
- Lead Sponsor
- Massachusetts General Hospital
- Brief Summary
To estimate the clinical effectiveness of wireless physiologic monitoring of women in the first 24 hours after cesarean delivery at Mbarara Regional Referral Hospital
- Detailed Description
Women in sub-Saharan Africa have the highest rates of morbidity and mortality during childbirth. Despite significant increases in facility-based childbirth, quality gaps at the facility have limited reductions in maternal deaths. Infrequent monitoring of women around childbirth is a major gap in care that leads to delays in life-saving interventions. Simple increases in staffing will not overcome this gap, thus necessitating new strategies.
This project aims to use a simple wireless monitor to improve the detection of complications immediately after childbirth and allow clinicians to provide life-saving interventions when needed. Using a hybrid clinical effectiveness-implementation approach women delivered by cesarean in Mbarara, Uganda will be recruited to wear a wireless physiologic monitor for 24 hours after delivery and their delivering obstetricians recruited to use the monitoring system, including the receipt of text message alerts should women develop abnormalities in physiologic signs. Rates of morbidity and mortality will be compared with a control group of women delivered by the same obstetricians. Clinical adoption and implementation will be assessed with the RE-AIM implementation framework and semi-structured interviews.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 3191
- Emergency cesarean delivery at MRRH
- Able to provide consent or have a guardian/attendant present who can consent
- Willing to wear the biosensor for 24 hours
- Willing remain in the postpartum unit for 24 hours
- Admitted to ICU directly after delivery
- Allergies or hypersensitivity to device materials
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Severe Maternal Outcome From completion of the cesarean delivery until hospital discharge from the procedure, an average of 3 days The primary effectiveness outcome was a composite measure of severe maternal morbidity (SMM) measured from enrollment until hospital discharge This composite measure is adapted from World Health Organization (WHO) near-miss morbidity criteria, as well as other severe maternal outcomes, including hysterectomy, cardiac arrest, prolonged unconsciousness, stroke, dialysis, intensive care admission, and death.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Mbarara Regional Referral Hospital
🇺🇬Mbarara, Uganda
Mbarara Regional Referral Hospital🇺🇬Mbarara, UgandaJoseph NgonziContact+256 70381833jngonzi@must.ac.ugHenry LugobeContact+256 774 030 593