Electrical Inhibition (EI): A Preliminary Study To Prevent The Uterine Contractions Of Human Preterm Labor And Preterm Birth
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Premature Birth
- Sponsor
- NYU Langone Health
- Locations
- 1
- Primary Endpoint
- Decrease tocodynamometric monitored preterm uterine contraction frequency
- Status
- Withdrawn
- Last Updated
- 8 years ago
Overview
Brief Summary
An electrical-inhibition (EI) uterine pacemaker device similar to an electrical heart pacemaker delivers a weak electrical current to the human uterus during active preterm labor to rapidly and safely inhibit the unwanted premature uterine contractions and possibly a preterm birth.
Detailed Description
Electrical intervention (EI) uses bipolar, constant-current (1-20 mA), square-wave pulses in 20% duty cycles. Women in active preterm labor have an electrode catheter placed into the posterior fornix of the vaginal canal. The EI current is given up to 80 minutes while monitoring tocodynamometric (toco) contractions and adjunct electrohysterographic (EHG) activity while continuously monitoring maternal vital signs, fetal heart rate and electrocardiogram (fECG). The study includes a pre-EI control period (C1); the EI period, when a 10-second current burst is delivered only during a contraction; and a post-EI control period (C2). The whole study will take a maximum of two hours. The uterine toco contraction frequency and adjunct EHG electrical activity are analyzed for changes caused by EI. Changes in maternal vital signs, fetal heart rate and fECG will determine EI side-effects.
Investigators
Eligibility Criteria
Inclusion Criteria
- •between 24 to 34 weeks pregnant with a singleton gestation;
- •in preterm labor as defined by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics,78 as follows:
- •persistent uterine contractions (4 every 20 minutes or 8 every 60 minutes)
- •And any one or more of the following:
- •Documented cervical change
- •\> 1cm cervical dilatation and progressing
- •\> 80% cervical effacement
- •anticipate a normal spontaneous vaginal delivery (NSVD).
- •at least 18 years of age
- •signed a written Informed Consent Document
Exclusion Criteria
- •severe preeclampsia
- •severe abruption placenta
- •rupture of amniotic membranes
- •frank chorioamnionitis
- •fetal death
- •fetal anomaly incompatible with life
- •severe fetal growth restriction (EFW \<5%)
- •mature fetal lung studies
- •maternal cardiac arrhythmias
- •a permanent cardiac pacemaker
Outcomes
Primary Outcomes
Decrease tocodynamometric monitored preterm uterine contraction frequency
Time Frame: 30 seconds
Measure changes in preterm uterine mechanical contraction frequency as assessed by the tocodynamometer. This will be done for the duration of the study.
Secondary Outcomes
- Decrease adjunct electrohysterographic monitored preterm uterine contraction electrical activity.(20 seconds)