Developing and Testing a Clinical Grade Magnetic Impedance Spectroscopy Device for Cervical Assessment to Predict Preterm Birth
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 127
- 试验地点
- 2
- 主要终点
- Cervical Resistivity
研究概览
简要总结
Every year, globally, about 15 million babies are born preterm (before 37 weeks). This number is rising. Preterm birth (PTB) complications are the leading cause of death among children under 5 years of age, responsible for nearly 1 million deaths annually. PTB poses a strain on scarce health resources: each very premature baby costs tens of thousands of pounds in newborn care. One in 4 babies born before 28 weeks develop neurological impairment, a parent often having to give up work to care for an affected child. The prediction and prevention of PTB remain challenging because current methods, such as measuring the cervix by ultrasound, have limited accuracy. If a technique that reliably predicts PTB could be developed, there are care measures that can be employed to delay birth to reduce long-term disability/impairment. The Investigators have been studying whether they can detect the changes in cervical tissue structure and composition that precede PTB by using very low current Electrical Impedance Spectroscopy (EIS). Evidence recently showed that women at high risk of PTB (history of previous PTB), who deliver preterm, including delivery before 28 weeks gestation, have lower cervical "resistance" in mid-pregnancy than those who deliver at term. With NIHR funding, the investigators have developed a new device, based on a technique called magnetic impedance spectroscopy (MIS) that should address limitations of the EIS device for assessing PTB risk. The investigators now want to refine the new MIS device by minimising the signals it receives from other tissues around the cervix and making its measurements at internal body temperature more stable. The researchers also conduct clinical experiments to test whether it predicts PTB better than the previous EIS device, and check whether pregnant women find its use acceptable. This information will allow them to obtain UK regulatory approval to test the device in larger trials.
详细描述
The studies will be undertaken at the Jessop Wing (JW) Maternity Unit of the Royal Hallamshire Hospital, a tertiary referral unit with annual birth statistics of approximately 8000 births per annum. The JW receives in utero transfers from > 6 other hospitals in South Yorkshire and houses the regional neonatal intensive care unit with high dependency care facilities equipped to deal with extremely premature births, including those born at gestational ages borderline for viability (23-26weeks). The unit is therefore suited for the care of women at high risk of premature delivery and is well suited to house this study. The clinician on the core research team for this application also accepts referrals for high risk antenatal care and surveillance of women most at risk of premature delivery from colleagues in referring hospitals.
To reach this objective, the Investigators will package the project into three work packages (WP) with target milestones over 36 months. The time frames for the study phases are outlined below.
WP1. DURATION - 30 MONTHS, M1-30. LEAD J. HEALEY
Objectives:
- To recruit high-calibre research staff (Postdoctoral Research Associate Clinical Engineer and Clinical Research Fellow) at project initiation.
- To refine/optimise the hardware and software of the MIS device to enable a clinical grade version - the MIS Mark 2 device (in collaboration with Arrow Technical).
- To apply for MHRA regulatory approvals for a device that can be employed for follow-on multicentre studies, towards eventual CE Marking post-project.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 —(Child, Adult, Older Adult)
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •≥ 16 years of age
- •no signs of cervical infection
- •no previous cervical surgery
- •had a normal cervical smear within the previous 3 years
- •identified as asymptomatic high-risk antenatally (Asymptomatic high-risk women participants)
- •Symptoms of preterm labour (Symptomatic Pregnant women participants)
排除标准
- •< 16 years of age
- •signs of cervical infection
- •previous cervical surgery
- •no cervical smear within previous 3 years
- •not identified as symptomatic high-risk antenatally (Asymptomatic high-risk women participants)
- •No symptoms of preterm labour (Symptomatic Pregnant women participants)
结局指标
主要结局
Cervical Resistivity
时间窗: Week 26-28 of pregnancy
Cervical resistivity measured by use of Magnetic Impedance Spectroscopy probe. Probe measurements will be compared against birth outcomes to determine predictive ability of probe for pre-term birth. Measuring changes from week 20-22 visit.
次要结局
- Assess service-user acceptability of the MIS device(Within 1 month of week 26-28 visit)
- Cost-effectiveness(At 24 months)
