Preterm BirthATOPSNCT03865108
Mechanical Environment Pregnancy With Short Cervix
A study testing Ultrasound imaging and Cervical speculum examination in people with Preterm Birth, run by Columbia University at 1 site in United States.
Trial summary
The objective of this study is to quantify the mechanical environment of pregnancies complicated by a short cervix and randomized in the Trial of Pessary in Singleton Pregnancies with a Short Cervix study with ultrasound imaging and aspiration. Read more about this study
- Who is it for?
- Ages 18 to 50 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Preterm Birth
- What is being tested?
- Ultrasound imaging and Cervical speculum examination
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 36 participants
- Where
- 1 siteUnited States
- Study dates
- 5 Jun 2017to 23 Jan 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Singleton gestation.
- Twin gestation reduced to singleton either spontaneously or therapeutically, is not eligible unless the reduction occurred before 13 weeks 6 days project gestational age.
- Higher order multifetal gestations reduced to singletons are not eligible.
- Gestational age at randomization between 16 weeks 0 days and 23 weeks 6 days based on clinical information and evaluation of the earliest ultrasound as described in Gestational Age.
- Cervical length on transvaginal examination of less than or equal to 20 mm within 10 days prior to randomization by a study certified sonographer. There is no lower cervical length threshold.
Who cannot join
- Women who are ineligible for the TOPS trial.
Trial locations and contacts
1 site in 1 country.
United States1 site
Columbia University Irving Medical Center
New York, New York, 10032
About this study
Official title: Quantifying the Mechanical Environment of Pregnancy Complicated With a Short Cervix With Ultrasound Imaging and Aspiration - Ancillary Study to the Trial of Pessary in Singleton Pregnancies Trial
The objective of this study is to quantify the mechanical environment of pregnancies complicated by a short cervix and randomized in the Trial of Pessary in Singleton Pregnancies with a Short Cervix study with ultrasound imaging and aspiration.
Aim 1: To determine the biomechanical properties of a prematurely remodeled cervix.
Read more
Aim 2: To determine the impact of pessary placement on the biomechanical properties of a prematurely remodeled cervix and establish if the pessary reduces the mechanical load on the cervix through computer modeling informed by ultrasonographic measurement and cervical stiffness measurements.
Aim 3: To determine if the differences in the cervical biomechanical properties after pessary placement lead to improved birth outcomes as compared to the progesterone only group.
Read the detailed description
In pregnancy the mother carries the growing fetus throughout gestation as her body prepares for delivery. This maternal preparation includes anatomical, physiological, and biochemical changes of the uterus, cervix, and ligaments that surround and support the uterus and cervix. For a successful term delivery, the uterus, cervix and supporting ligaments must remodel in a coordinated fashion to allow for adequate dilation and effacement of the cervix and delivery of the fetus.
Preterm birth (PTB) is the leading cause of neonatal death. Premature babies that survive face a significantly increased risk of long-term disabilities, such as mental retardation, learning and behavioral problems, cerebral palsy, seizures, respiratory problems, gastrointestinal problems and vision/hearing loss. PTB is also significant cost factor in healthcare. In 2003, a study in the US approximated neonatal costs to be $224,400 for a newborn that weighed 500-700g (extreme-severe preterm range) verse $1,000 at over 3,000g. These costs increase exponentially with decreasing gestational age and weight. In 2007, an Institute of Medicine report entitled "Preterm Birth" found that the 550,000 preemies born each year in the U.S. cost $26 billion annually, mostly related to prolonged care in neonatal intensive care units. The pathophysiology of PTB is multi-factorial and the degree of severity spans a wide range, with pregnancy outcomes depending on a combination of congenital, anatomical, obstetric, epidemiological, and biochemical factors. Because of these confounding factors PTB rates in the US and around the world are on the rise and diagnostic methods to identify high-risk women for PTB remain elusive.
Premature cervical remodeling which leads to softening/shortening of the cervix (i.e., a mechanical failure of the cervix) is one of the leading contributors to the birth of a severely preterm neonate. The true frequency and impact is unknown because diagnosing this condition remains elusive and the biomechanical environment of pregnancy is unknown. The pathophysiology is hypothesized to be multi-factorial leading to a common feature of a structurally weak and excessively soft cervix that is unable to remain closed and to support the fetus. Recently, it has been demonstrated that these preterm cervical changes may in some cause premature cervical shortening as measured by transvaginal ultrasound imaging. When this occurs, treatment with progesterone suppositories has been demonstrated to reduce the risk of preterm delivery. However, this treatment is not effective in many cases; probably because a short cervix is a late manifestation of the underlying biostructural alterations in the uterus, cervix and supporting ligaments.
Many clinically-relevant advances in the field of orthopedics and gynecology (i.e., assessing the causes of uterine prolapse have been attributed to the accurate biomechanical modeling of the anatomy and tissue properties using finite element analysis (FEA). FEA is a computer simulation that computes tissue stretch (i.e., tissue strain), tissue stress, and reaction forces when external mechanical forces are applied to the system given the tissue's geometric shape and mechanical properties. Lastly, directly measuring the mechanical stiffness of the uterine cervix through use of a simple aspiration device has shown that in normal pregnancy cervical tissue softens starting in the 1st trimester and continues until dilation. These studies have also shown that using a simple mechanical aspirator applied to the end of the cervix protruding into the vaginal canal has zero adverse effects on the patient, where the measurement can be performed during a standard speculum exam.
The cervical pessary has been proposed as an additional option for treatment in pregnancies with a short cervix. It offers additional theoretical benefits over the cerclage, in that it does not require surgical intervention. Its proposed mechanisms of action include a) angling the cervix toward the posterior, bringing the external os toward the sacrum, b) mechanically closing the cervix with the constraining geometry of the device, and c) preserving the mucous plug. These mechanisms of action involve lowering the mechanical stresses on the area of the internal os, potentially modifying the release of the enzymes and inflammatory markers involved in the preterm birth pathway. However, it is still unknown if the pessary relieves the mechanical load on the cervix because a biomechanical investigation of its function has not been performed. Therefore, the investigator plans to study a group of women with a short cervix randomized in an existing trial: AAAR1353 - A Randomized Trial of Pessary in Singleton Pregnancies with a Short Cervix (TOPS) in order to better understand the function and effect of the cervical pessary on the biomechanical support of the cervix in addition to its effect on its tissue properties and structural integrity. If a specific maternal utero-cervical phenotype can be located, where the placement of the cervical pessary reduces the mechanical load on the cervical internal os and therefore leads to a decreased incidence of preterm birth, then a more personalized treatment may be possible for patients who fall within this specific phenotype in the future.
For the substudy, a total of 36 women will be recruited and randomized through the existing TOPS trial (18 randomized to Pessary and Progesterone and 18 randomized to progesterone only). Obstetric and gynecologic history, age, race, body mass index, smoking history, and outcome of the current pregnancy will be recorded for all patients.
- Conditions
- Preterm Birth
- Being tested
- Ultrasound imaging, Cervical speculum examination
- Keywords
- Pessary, Cervix, Biomechanical environment, Aspiration, Computer simulation models
- Medical subject headings
- Premature Birth
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultrasound imagingProcedure or surgery
Also called Sonography
This standard of care procedure is being done for research purposes and used to collect information and measure the maternal and fetal anatomy.
Cervical speculum examinationProcedure or surgery
Also called Cervical aspiration
This standard of care procedure is being done for research purposes and used to collect tissue and measure the strength and stiffness of cervix.
| Study group | Role | What they receive |
|---|---|---|
| Pessary and Progesterone | Experimental | Women already receiving a pessary in addition to the standard progesterone through the TOPS trial will undergo ultrasound imaging and cervical speculum examination for information collection. Receives: Procedure: Ultrasound imaging; Procedure: Cervical speculum examination |
| Progesterone only | Placebo comparator | Women already receiving the standard progesterone only will undergo ultrasound imaging and cervical speculum examination for information collection. Receives: Procedure: Ultrasound imaging; Procedure: Cervical speculum examination |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mechanical compliance index of the cervix
The mechanical compliance index of the cervix is the percentage of the cervical tissue above a 1.2 stretch threshold under a uniform IUP. This index is calculated using finite element computational methods, given the maternal anatomy and cervical stiffness measured from the aspiration tool. The mechanical compliance index of the cervix will be measured at both time points within the study timeframe, and the change of the mechanical compliance index between the two time points will be assessed. The main outcome parameter will be the mechanical compliance index at the baseline time point, and the other two outcome measures will be used as validation data points.
Measured: Baseline (at diagnosis of short cervix), third trimester (approximately 26-30 weeks)
Secondary outcomes (1)
Number of participants with spontaneous preterm birth
The investigator will tally the number of women who receive Intervention of Pessary and experience spontaneous preterm birth
Measured: Pregnancy duration, an average of up to 40 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Mar 2019
- Study start5 Jun 2017
- Primary completion23 Jan 2021
- Study completion23 Jan 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (23)Papers the sponsor has linked to this study.
- Other trials for Preterm BirthStudies of the same condition, open and under way.
- More trials run by Columbia UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- The two arms are not randomized under this sub study but carried over from the existing TOPS trial.
- Masking
- None (open label)
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Columbia University
- Sponsor type
- University, hospital or other
- Collaborators
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- Responsible party
- Principal investigator, Kristin Myers, Columbia University
- Investigators
- Kristin Myers, PhD, Principal investigator, Associate Professor of Mechanical Engineering
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03865108
- Sponsor's protocol ID
- AAAO4956 sub-study
- Other IDs
- 3UG1HD040485-18S1
- Acronym
- ATOPS
- Status last verified
- Sep 2024
- First submitted
- 22 Feb 2019
- Last updated
- 23 Sep 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Lorenz JM. The outcome of extreme prematurity. Semin Perinatol. 2001 Oct;25(5):348-59. doi: 10.1053/sper.2001.27164.
PubMed 11707021Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008 Jan 5;371(9606):75-84. doi: 10.1016/S0140-6736(08)60074-4.
PubMed 18177778Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol. 2003 Sep;102(3):488-92. doi: 10.1016/s0029-7844(03)00617-3.
PubMed 12962929Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samuels P. Cervical competence as a continuum: a study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol. 1995 Apr;172(4 Pt 1):1097-103; discussion 1104-6. doi: 10.1016/0002-9378(95)91469-2.
PubMed 7726247Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, Rubens C, Menon R, Van Look PF. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010 Jan;88(1):31-8. doi: 10.2471/BLT.08.062554. Epub 2009 Sep 25.
PubMed 20428351Schmidt H, Galbusera F, Rohlmann A, Shirazi-Adl A. What have we learned from finite element model studies of lumbar intervertebral discs in the past four decades? J Biomech. 2013 Sep 27;46(14):2342-55. doi: 10.1016/j.jbiomech.2013.07.014. Epub 2013 Aug 3.
PubMed 23962527Ashton-Miller JA, Delancey JO. On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng. 2009;11:163-76. doi: 10.1146/annurev-bioeng-061008-124823.
PubMed 19591614Mazza E, Nava A, Bauer M, Winter R, Bajka M, Holzapfel GA. Mechanical properties of the human uterine cervix: an in vivo study. Med Image Anal. 2006 Apr;10(2):125-36. doi: 10.1016/j.media.2005.06.001. Epub 2005 Sep 6.
PubMed 16143559Bauer M, Mazza E, Nava A, Zeck W, Eder M, Bajka M, Cacho F, Lang U, Holzapfel GA. In vivo characterization of the mechanics of human uterine cervices. Ann N Y Acad Sci. 2007 Apr;1101:186-202. doi: 10.1196/annals.1389.004. Epub 2007 Mar 15.
PubMed 17363446Mazza E, Nava A, Hahnloser D, Jochum W, Bajka M. The mechanical response of human liver and its relation to histology: an in vivo study. Med Image Anal. 2007 Dec;11(6):663-72. doi: 10.1016/j.media.2007.06.010. Epub 2007 Jul 5.
PubMed 17719834Bauer M, Mazza E, Jabareen M, Sultan L, Bajka M, Lang U, Zimmermann R, Holzapfel GA. Assessment of the in vivo biomechanical properties of the human uterine cervix in pregnancy using the aspiration test: a feasibility study. Eur J Obstet Gynecol Reprod Biol. 2009 May;144 Suppl 1:S77-81. doi: 10.1016/j.ejogrb.2009.02.025. Epub 2009 Mar 13.
PubMed 19285777Badir S, Mazza E, Zimmermann R, Bajka M. Cervical softening occurs early in pregnancy: characterization of cervical stiffness in 100 healthy women using the aspiration technique. Prenat Diagn. 2013 Aug;33(8):737-41. doi: 10.1002/pd.4116. Epub 2013 Apr 29.
PubMed 23553612Badir S, Bajka M, Mazza E. A novel procedure for the mechanical characterization of the uterine cervix during pregnancy. J Mech Behav Biomed Mater. 2013 Nov;27:143-53. doi: 10.1016/j.jmbbm.2012.11.020. Epub 2012 Dec 11.
PubMed 23274486Hollenstein M, Bugnard G, Joos R, Kropf S, Villiger P, Mazza E. Towards laparoscopic tissue aspiration. Med Image Anal. 2013 Dec;17(8):1037-45. doi: 10.1016/j.media.2013.06.001. Epub 2013 Jun 19.
PubMed 23876854Mazza E, Parra-Saavedra M, Bajka M, Gratacos E, Nicolaides K, Deprest J. In vivo assessment of the biomechanical properties of the uterine cervix in pregnancy. Prenat Diagn. 2014 Jan;34(1):33-41. doi: 10.1002/pd.4260.
PubMed 24155152
Study at a glance
From the registry record, last updated by the sponsor on 23 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Quantifying the Mechanical Environment of Pregnancy Complicated With a Short Cervix With Ultrasound Imaging and Aspiration - Ancillary Study to the Trial of Pessary in Singleton Pregnancies Trial
- ClinicalTrials.gov ID
- NCT03865108
- Acronym / sponsor ID
- ATOPS / AAAO4956 sub-study
- Conditions
- Preterm Birth
- Keywords
- Pessary, Cervix, Biomechanical environment, Aspiration, Computer simulation models
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Columbia UniversityUniversity, hospital or other
- Collaborators
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- Study start
- 5 Jun 2017 (actual)
- Primary completion
- 23 Jan 2021 (actual)
- Study completion
- 23 Jan 2021 (actual)
- First posted
- 6 Mar 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to quantify the mechanical environment of pregnancies complicated by a short cervix and randomized in the Trial of Pessary in Singleton Pregnancies with a Short Cervix study with ultrasound imaging and aspiration.
Aim 1: To determine the biomechanical properties of a prematurely remodeled cervix.
Aim 2: To determine the impact of pessary placement on the biomechanical properties of a prematurely remodeled cervix and establish if the pessary reduces the mechanical load on the cervix through computer modeling informed by ultrasonographic measurement and cervical stiffness measurements.
Aim 3: To determine if the differences in the cervical biomechanical properties after pessary placement lead to improved birth outcomes as compared to the progesterone only group.
Detailed description
In pregnancy the mother carries the growing fetus throughout gestation as her body prepares for delivery. This maternal preparation includes anatomical, physiological, and biochemical changes of the uterus, cervix, and ligaments that surround and support the uterus and cervix. For a successful term delivery, the uterus, cervix and supporting ligaments must remodel in a coordinated fashion to allow for adequate dilation and effacement of the cervix and delivery of the fetus.
Preterm birth (PTB) is the leading cause of neonatal death. Premature babies that survive face a significantly increased risk of long-term disabilities, such as mental retardation, learning and behavioral problems, cerebral palsy, seizures, respiratory problems, gastrointestinal problems and vision/hearing loss. PTB is also significant cost factor in healthcare. In 2003, a study in the US approximated neonatal costs to be $224,400 for a newborn that weighed 500-700g (extreme-severe preterm range) verse $1,000 at over 3,000g. These costs increase exponentially with decreasing gestational age and weight. In 2007, an Institute of Medicine report entitled "Preterm Birth" found that the 550,000 preemies born each year in the U.S. cost $26 billion annually, mostly related to prolonged care in neonatal intensive care units. The pathophysiology of PTB is multi-factorial and the degree of severity spans a wide range, with pregnancy outcomes depending on a combination of congenital, anatomical, obstetric, epidemiological, and biochemical factors. Because of these confounding factors PTB rates in the US and around the world are on the rise and diagnostic methods to identify high-risk women for PTB remain elusive.
Premature cervical remodeling which leads to softening/shortening of the cervix (i.e., a mechanical failure of the cervix) is one of the leading contributors to the birth of a severely preterm neonate. The true frequency and impact is unknown because diagnosing this condition remains elusive and the biomechanical environment of pregnancy is unknown. The pathophysiology is hypothesized to be multi-factorial leading to a common feature of a structurally weak and excessively soft cervix that is unable to remain closed and to support the fetus. Recently, it has been demonstrated that these preterm cervical changes may in some cause premature cervical shortening as measured by transvaginal ultrasound imaging. When this occurs, treatment with progesterone suppositories has been demonstrated to reduce the risk of preterm delivery. However, this treatment is not effective in many cases; probably because a short cervix is a late manifestation of the underlying biostructural alterations in the uterus, cervix and supporting ligaments.
Many clinically-relevant advances in the field of orthopedics and gynecology (i.e., assessing the causes of uterine prolapse have been attributed to the accurate biomechanical modeling of the anatomy and tissue properties using finite element analysis (FEA). FEA is a computer simulation that computes tissue stretch (i.e., tissue strain), tissue stress, and reaction forces when external mechanical forces are applied to the system given the tissue's geometric shape and mechanical properties. Lastly, directly measuring the mechanical stiffness of the uterine cervix through use of a simple aspiration device has shown that in normal pregnancy cervical tissue softens starting in the 1st trimester and continues until dilation. These studies have also shown that using a simple mechanical aspirator applied to the end of the cervix protruding into the vaginal canal has zero adverse effects on the patient, where the measurement can be performed during a standard speculum exam.
The cervical pessary has been proposed as an additional option for treatment in pregnancies with a short cervix. It offers additional theoretical benefits over the cerclage, in that it does not require surgical intervention. Its proposed mechanisms of action include a) angling the cervix toward the posterior, bringing the external os toward the sacrum, b) mechanically closing the cervix with the constraining geometry of the device, and c) preserving the mucous plug. These mechanisms of action involve lowering the mechanical stresses on the area of the internal os, potentially modifying the release of the enzymes and inflammatory markers involved in the preterm birth pathway. However, it is still unknown if the pessary relieves the mechanical load on the cervix because a biomechanical investigation of its function has not been performed. Therefore, the investigator plans to study a group of women with a short cervix randomized in an existing trial: AAAR1353 - A Randomized Trial of Pessary in Singleton Pregnancies with a Short Cervix (TOPS) in order to better understand the function and effect of the cervical pessary on the biomechanical support of the cervix in addition to its effect on its tissue properties and structural integrity. If a specific maternal utero-cervical phenotype can be located, where the placement of the cervical pessary reduces the mechanical load on the cervical internal os and therefore leads to a decreased incidence of preterm birth, then a more personalized treatment may be possible for patients who fall within this specific phenotype in the future.
For the substudy, a total of 36 women will be recruited and randomized through the existing TOPS trial (18 randomized to Pessary and Progesterone and 18 randomized to progesterone only). Obstetric and gynecologic history, age, race, body mass index, smoking history, and outcome of the current pregnancy will be recorded for all patients.
Study design
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- The two arms are not randomized under this sub study but carried over from the existing TOPS trial.
| Arm | Type | Receives |
|---|---|---|
| Pessary and Progesterone | Experimental | Procedure: Ultrasound imaging, Procedure: Cervical speculum examinationWomen already receiving a pessary in addition to the standard progesterone through the TOPS trial will undergo ultrasound imaging and cervical speculum examination for information collection. |
| Progesterone only | Placebo comparator | Procedure: Ultrasound imaging, Procedure: Cervical speculum examinationWomen already receiving the standard progesterone only will undergo ultrasound imaging and cervical speculum examination for information collection. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Singleton gestation.
- Gestational age at randomization between 16 weeks 0 days and 23 weeks 6 days based on clinical information and evaluation of the earliest ultrasound as described in Gestational Age.
- Cervical length on transvaginal examination of less than or equal to 20 mm within 10 days prior to randomization by a study certified sonographer. There is no lower cervical length threshold.
Key exclusion criteria (1 listed)
- Women who are ineligible for the TOPS trial.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ultrasound imagingAlso: SonographyThis standard of care procedure is being done for research purposes and used to collect information and measure the maternal and fetal anatomy. | Procedure or surgery | Pessary and Progesterone, Progesterone only |
| Cervical speculum examinationAlso: Cervical aspirationThis standard of care procedure is being done for research purposes and used to collect tissue and measure the strength and stiffness of cervix. | Procedure or surgery | Pessary and Progesterone, Progesterone only |
Primary outcome
Mechanical compliance index of the cervix
Time frame: Baseline (at diagnosis of short cervix), third trimester (approximately 26-30 weeks)
The mechanical compliance index of the cervix is the percentage of the cervical tissue above a 1.2 stretch threshold under a uniform IUP. This index is calculated using finite element computational methods, given the maternal anatomy and cervical stiffness measured from the aspiration tool. The mechanical compliance index of the cervix will be measured at both time points within the study timeframe, and the change of the mechanical compliance index between the two time points will be assessed. The main outcome parameter will be the mechanical compliance index at the baseline time point, and the other two outcome measures will be used as validation data points.
1 secondary outcome
Number of participants with spontaneous preterm birth
Time frame: Pregnancy duration, an average of up to 40 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Sep 2024.
- Background: PubMed 11707021Lorenz JM. The outcome of extreme prematurity. Semin Perinatol. 2001 Oct;25(5):348-59. doi: 10.1053/sper.2001.27164.
- Background: PubMed 18177778Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008 Jan 5;371(9606):75-84. doi: 10.1016/S0140-6736(08)60074-4.
- Background: PubMed 12962929Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol. 2003 Sep;102(3):488-92. doi: 10.1016/s0029-7844(03)00617-3.
- Background: PubMed 7726247Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samuels P. Cervical competence as a continuum: a study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol. 1995 Apr;172(4 Pt 1):1097-103; discussion 1104-6. doi: 10.1016/0002-9378(95)91469-2.
- Background: PubMed 20428351Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, Rubens C, Menon R, Van Look PF. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010 Jan;88(1):31-8. doi: 10.2471/BLT.08.062554. Epub 2009 Sep 25.
- Background: PubMed 23962527Schmidt H, Galbusera F, Rohlmann A, Shirazi-Adl A. What have we learned from finite element model studies of lumbar intervertebral discs in the past four decades? J Biomech. 2013 Sep 27;46(14):2342-55. doi: 10.1016/j.jbiomech.2013.07.014. Epub 2013 Aug 3.
- Background: PubMed 19591614Ashton-Miller JA, Delancey JO. On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng. 2009;11:163-76. doi: 10.1146/annurev-bioeng-061008-124823.
- Background: PubMed 16143559Mazza E, Nava A, Bauer M, Winter R, Bajka M, Holzapfel GA. Mechanical properties of the human uterine cervix: an in vivo study. Med Image Anal. 2006 Apr;10(2):125-36. doi: 10.1016/j.media.2005.06.001. Epub 2005 Sep 6.
- Background: PubMed 17363446Bauer M, Mazza E, Nava A, Zeck W, Eder M, Bajka M, Cacho F, Lang U, Holzapfel GA. In vivo characterization of the mechanics of human uterine cervices. Ann N Y Acad Sci. 2007 Apr;1101:186-202. doi: 10.1196/annals.1389.004. Epub 2007 Mar 15.
- Background: PubMed 17719834Mazza E, Nava A, Hahnloser D, Jochum W, Bajka M. The mechanical response of human liver and its relation to histology: an in vivo study. Med Image Anal. 2007 Dec;11(6):663-72. doi: 10.1016/j.media.2007.06.010. Epub 2007 Jul 5.
- Background: PubMed 19285777Bauer M, Mazza E, Jabareen M, Sultan L, Bajka M, Lang U, Zimmermann R, Holzapfel GA. Assessment of the in vivo biomechanical properties of the human uterine cervix in pregnancy using the aspiration test: a feasibility study. Eur J Obstet Gynecol Reprod Biol. 2009 May;144 Suppl 1:S77-81. doi: 10.1016/j.ejogrb.2009.02.025. Epub 2009 Mar 13.
- Background: PubMed 23553612Badir S, Mazza E, Zimmermann R, Bajka M. Cervical softening occurs early in pregnancy: characterization of cervical stiffness in 100 healthy women using the aspiration technique. Prenat Diagn. 2013 Aug;33(8):737-41. doi: 10.1002/pd.4116. Epub 2013 Apr 29.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kristin Myers, PhD principal investigator
Associate Professor of Mechanical Engineering
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ultrasound imaging and Cervical speculum examination in people with Preterm Birth, run by Columbia University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 23 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mechanical compliance index of the cervix (time frame: Baseline (at diagnosis of short cervix), third trimester (approximately 26-30 weeks)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03865108, which also lists 23 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Sep 2024.