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Wireless Physiologic Monitoring in Postpartum Women

Not Applicable
Active, not recruiting
Conditions
Maternal Death During Childbirth
Pregnancy 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
Inclusion Criteria
  • 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
Exclusion Criteria
  • Admitted to ICU directly after delivery
  • Allergies or hypersensitivity to device materials

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Severe Maternal OutcomeFrom 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
NameTimeMethod

Trial Locations

Locations (1)

Mbarara Regional Referral Hospital

🇺🇬

Mbarara, Uganda

Mbarara Regional Referral Hospital
🇺🇬Mbarara, Uganda
Joseph Ngonzi
Contact
+256 70381833
jngonzi@must.ac.ug
Henry Lugobe
Contact
+256 774 030 593

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