Complicated Twin PregnancyNCT02732717
The Value of Prenatal Ultrasound in Complicated Twin Pregnancy and Its Correlation With Chromosomal Anomalies
An observational study of Complicated Twin Pregnancy, run by First Affiliated Hospital Xi'an Jiaotong University at 1 site in China.
Trial summary
Recent years, women with infertility have become more and more and thus assisted reproductive technology has been applied in a broad range. And the quantities of twin pregnancies are larger and larger. Read more about this study
- Who is it for?
- Any age, women onlyHealthy volunteers can take part
- Conditions the study is for
- Complicated Twin Pregnancy
- What is being tested?
- ultrasound (observation)
- How many people
- 580 participants
- Where
- 1 siteChina
- Study dates
- Apr 2016to 1 Dec 2022
- Phase
- Observational
- 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 Any age
- Women only
- Healthy volunteers accepted
- Child, Adult, Older adult
Study population: pregnant women who visit the First Affiliated Hospital of Xian Jiaotong University.
Who may be able to join
- women with twin pregnancy starting at 11-14 weeks of gestation.
Who cannot join
- women with triplet pregnancy;
- complicating with acute internal or surgical diseases.
Trial locations and contacts
1 site in 1 country.
China1 site
First affiliated hospital of Xian jiaotong university
Xi'an, Shaanxi, 710061
About this study
Official title: The Value of Prenatal Ultrasound in the Diagnosis and Monitoring of Complicated Twin Pregnancy and Its Correlation With Chromosomal Anomalies of Twin
Recent years, women with infertility have become more and more and thus assisted reproductive technology has been applied in a broad range. And the quantities of twin pregnancies are larger and larger. However, complicated twin pregnancy subsequently increased including selective intrauterine growth restriction (sIUGR), twin growth discordance, twin transfusion syndrome (TTTS) and intrauterine fetal death (IUFD). The occurrence of complicated twin pregnancy has been the leading cause of morbidity and mortality in twin and mother. Meanwhile, twin pregnancy, especially monochorionic type has suffered from higher rate of chromosomal anomalies and structural anomalies. Therefore, it is important that more attention should be paid to the prediction, clinical evaluation and the occurrence of chromosomal anomalies and structural anomalies in complicated twin pregnancy.
So far, prenatal ultrasound has been acknowledged as the best method for prenatal diagnosis and evaluation in twin pregnancy. By means of the application of prenatal ultrasound, the detection of fetal chromosome, and secondary correlation analysis, the investigators try to build prenatal ultrasound monitoring system of twin pregnancy and provide evidences for the choice of intervention and delivery time, in order to decrease the morbidity and mortality of twin and improve perinatal short and long outcomes.
The goals of this study are as below: (1) primary goal: the prediction of complicated twin pregnancy by using prenatal ultrasound; (2) primary goal: the clinical evaluation of perinatal outcomes in twin pregnancy by using prenatal ultrasound; (3) secondary goal: the analysis of the correlation between prenatal ultrasound and fetal anomalies.
Read the detailed description
The study is designed as an observational prospective cohort study. The primary outcome is complicated twin pregnancy (sIUGR, TTTS, IUFD, twin growth discordance). The main exposed factors are discordance of crown-rump length more than 20%, discordance of nuchal translucency more than 20%, either of twin with abnormal amniotic fluid (polyhydramnios or oligoamnios), either of twin with abnormal umbilical artery flow (elevated resistance index, absent or reverse diastolic flow), either of twin with abnormal middle cerebral artery flow (more than 1.5Mom), either of twin with abnormal ductus venous flow (absent or reverse a-wave). Meanwhile, some demographic data are to be collected and confounding factors are to be analyzed.
Women with twin pregnancy who are examined in the department are enrolled in this study. Ultrasound will be done in 11-13+6 weeks, 16-18 weeks, 22-24 weeks, 30-32 weeks and 37-39 weeks, and perinatal outcomes are to be collected, including the diagnosis of complicated twin pregnancy, when it happens, ultrasound indices, delivery mode, delivery time, birth weight, neonatal outcomes.
When there are indications for the detection of fetal chromosome, women are probably advised to have this examination, such as non-invasive DNA, amniocentesis, umbilical cord screening, as appropriate, and written informed consent will be achieved from every patient.
- Conditions
- Complicated Twin Pregnancy
- Being tested
- ultrasound (observation)
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ultrasound (observation)Other
Important sonographic indices are to be collected from 11-14 weeks, 16-18 weeks, 22-24 weeks, 30-32 weeks and 37-39 weeks,including crown-rump length, nuchal translucency, amniotic fluid, umbilical artery flow, middle cerebral artery flow,ductus venous flow. It is observational.
Conditions as below are thought abnormal: discordance of crown-rump length more than 20%, discordance of nuchal translucency more than 20%, either of twin with abnormal amniotic fluid (polyhydramnios or oligoamnios), either of twin with abnormal umbilical artery flow (elevated resistance index, absent or reverse diastolic flow), either of twin with abnormal middle cerebral artery flow (more than 1.5Mom), either of twin with abnormal ductus venous flow (absent or reverse a-wave).
| Study group | Role | What they receive |
|---|---|---|
| abnormal ultrasound index | twin pregnancy with abnormal ultrasound index Receives: Other: ultrasound (observation) | |
| normal ultrasound index | twin pregnancy with normal ultrasound index Receives: Other: ultrasound (observation) |
What is being measured
The primary outcome is the main question the study is designed to answer.
the occurrence of complicated twin pregnancy as assessed by prenatal ultrasound
It is referred to the occurrence of at least one situation described as below. sIUGR is defined as one fetus with birth weight<the 10th percentile for gestational age and the discordance of intertwin weight is more than 20%; twin growth discordance is defined as the discordance of intertwin weight is more than 20%; TTTS:Stage I-discordant amnionic fluid volumes described as one fetus with polyhydramnios (maximum vertical pocket≥8cm) and the other fetus with oligoamnios (maximum vertical pocket<2cm), but urine is visible in the bladder of donor twin.Stage II-criteria of stage I, but urine is not visible in donor bladder.Stage III-criteria of stage II and abnormal Doppler studies of the umbilical artery, ductus venosus or umbilical vein. Stage IV-ascites or frank hydrops in either twin. Stage V-demise of either fetus;IUFD is referred to the death of twins in the uterine.
Measured: up to two years
Secondary outcomes (1)
without occurrence of complicated twin pregnancy as assessed by prenatal ultrasound
It is referred to no occurrence of any situation described as below. sIUGR is defined as one fetus with birth weight<the 10th percentile for gestational age and the discordance of intertwin weight is more than 20%; twin growth discordance is defined as the discordance of intertwin weight is more than 20%; TTTS:Stage I-discordant amnionic fluid volumes described as one fetus with polyhydramnios (maximum vertical pocket≥8cm) and the other fetus with oligoamnios (maximum vertical pocket<2cm), but urine is visible in the bladder of donor twin.Stage II-criteria of stage I, but urine is not visible in donor bladder.Stage III-criteria of stage II and abnormal Doppler studies of the umbilical artery, ductus venosus or umbilical vein. Stage IV-ascites or frank hydrops in either twin. Stage V-demise of either fetus;IUFD is referred to the death of twins in the uterine.
Measured: up to two years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Apr 2016 (estimated)
- Study startApr 2016
- Primary completion1 Dec 2021 (estimated)
- Study completion1 Dec 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Complicated Twin PregnancyStudies of the same condition, open and under way.
- More trials run by First Affiliated Hospital Xi'an Jiaotong 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
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 580 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Zhen Han, Phd, Study chair, First Affiliated Hospital of Xian Jiaotong University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02732717
- Sponsor's protocol ID
- XJTU1AF-CRS-2015-003
- Status last verified
- Mar 2021
- First submitted
- 16 Mar 2016
- Last updated
- 8 Mar 2021
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Mar 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Value of Prenatal Ultrasound in the Diagnosis and Monitoring of Complicated Twin Pregnancy and Its Correlation With Chromosomal Anomalies of Twin
- ClinicalTrials.gov ID
- NCT02732717
- Acronym / sponsor ID
- XJTU1AF-CRS-2015-003
- Conditions
- Complicated Twin Pregnancy
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 580 participants (estimated)
- Lead sponsor
- First Affiliated Hospital Xi'an Jiaotong UniversityUniversity, hospital or other
- Study start
- Apr 2016
- Primary completion
- 1 Dec 2021 (estimated)
- Study completion
- 1 Dec 2022 (estimated)
- First posted
- 11 Apr 2016 (estimated)
- 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.
Recent years, women with infertility have become more and more and thus assisted reproductive technology has been applied in a broad range. And the quantities of twin pregnancies are larger and larger. However, complicated twin pregnancy subsequently increased including selective intrauterine growth restriction (sIUGR), twin growth discordance, twin transfusion syndrome (TTTS) and intrauterine fetal death (IUFD). The occurrence of complicated twin pregnancy has been the leading cause of morbidity and mortality in twin and mother. Meanwhile, twin pregnancy, especially monochorionic type has suffered from higher rate of chromosomal anomalies and structural anomalies. Therefore, it is important that more attention should be paid to the prediction, clinical evaluation and the occurrence of chromosomal anomalies and structural anomalies in complicated twin pregnancy.
So far, prenatal ultrasound has been acknowledged as the best method for prenatal diagnosis and evaluation in twin pregnancy. By means of the application of prenatal ultrasound, the detection of fetal chromosome, and secondary correlation analysis, the investigators try to build prenatal ultrasound monitoring system of twin pregnancy and provide evidences for the choice of intervention and delivery time, in order to decrease the morbidity and mortality of twin and improve perinatal short and long outcomes.
The goals of this study are as below: (1) primary goal: the prediction of complicated twin pregnancy by using prenatal ultrasound; (2) primary goal: the clinical evaluation of perinatal outcomes in twin pregnancy by using prenatal ultrasound; (3) secondary goal: the analysis of the correlation between prenatal ultrasound and fetal anomalies.
Detailed description
The study is designed as an observational prospective cohort study. The primary outcome is complicated twin pregnancy (sIUGR, TTTS, IUFD, twin growth discordance). The main exposed factors are discordance of crown-rump length more than 20%, discordance of nuchal translucency more than 20%, either of twin with abnormal amniotic fluid (polyhydramnios or oligoamnios), either of twin with abnormal umbilical artery flow (elevated resistance index, absent or reverse diastolic flow), either of twin with abnormal middle cerebral artery flow (more than 1.5Mom), either of twin with abnormal ductus venous flow (absent or reverse a-wave). Meanwhile, some demographic data are to be collected and confounding factors are to be analyzed.
Women with twin pregnancy who are examined in the department are enrolled in this study. Ultrasound will be done in 11-13+6 weeks, 16-18 weeks, 22-24 weeks, 30-32 weeks and 37-39 weeks, and perinatal outcomes are to be collected, including the diagnosis of complicated twin pregnancy, when it happens, ultrasound indices, delivery mode, delivery time, birth weight, neonatal outcomes.
When there are indications for the detection of fetal chromosome, women are probably advised to have this examination, such as non-invasive DNA, amniocentesis, umbilical cord screening, as appropriate, and written informed consent will be achieved from every patient.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| abnormal ultrasound index | – | Other: ultrasound (observation)twin pregnancy with abnormal ultrasound index |
| normal ultrasound index | – | Other: ultrasound (observation)twin pregnancy with normal ultrasound index |
Who may qualify
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
- Study population
- pregnant women who visit the First Affiliated Hospital of Xian Jiaotong University.
Key inclusion criteria (1 listed)
- women with twin pregnancy starting at 11-14 weeks of gestation.
Key exclusion criteria (2 listed)
- women with triplet pregnancy;
- complicating with acute internal or surgical diseases.
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 (observation)Important sonographic indices are to be collected from 11-14 weeks, 16-18 weeks, 22-24 weeks, 30-32 weeks and 37-39 weeks,including crown-rump length, nuchal translucency, amniotic fluid, umbilical artery flow, middle cerebral artery flow,ductus venous flow. It is observational. Conditions as below are thought abnormal: discordance of crown-rump length more than 20%, discordance of nuchal translucency more than 20%, either of twin with abnormal amniotic fluid (polyhydramnios or oligoamnios), either of twin with abnormal umbilical artery flow (elevated resistance index, absent or reverse diastolic flow), either of twin with abnormal middle cerebral artery flow (more than 1.5Mom), either of twin with abnormal ductus venous flow (absent or reverse a-wave). | Other | abnormal ultrasound index, normal ultrasound index |
Primary outcome
the occurrence of complicated twin pregnancy as assessed by prenatal ultrasound
Time frame: up to two years
It is referred to the occurrence of at least one situation described as below. sIUGR is defined as one fetus with birth weight<the 10th percentile for gestational age and the discordance of intertwin weight is more than 20%; twin growth discordance is defined as the discordance of intertwin weight is more than 20%; TTTS:Stage I-discordant amnionic fluid volumes described as one fetus with polyhydramnios (maximum vertical pocket≥8cm) and the other fetus with oligoamnios (maximum vertical pocket<2cm), but urine is visible in the bladder of donor twin.Stage II-criteria of stage I, but urine is not visible in donor bladder.Stage III-criteria of stage II and abnormal Doppler studies of the umbilical artery, ductus venosus or umbilical vein. Stage IV-ascites or frank hydrops in either twin. Stage V-demise of either fetus;IUFD is referred to the death of twins in the uterine.
1 secondary outcome
without occurrence of complicated twin pregnancy as assessed by prenatal ultrasound
Time frame: up to two years
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Mar 2021.
- Individual participant dataSharing planned: No
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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.
Zhen Han, Phd study chair
First Affiliated Hospital of Xian Jiaotong University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Complicated Twin Pregnancy, run by First Affiliated Hospital Xi'an Jiaotong University at 1 site in China.
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 1 inclusion and 2 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: status not confirmed, as of the sponsor's last update on 8 Mar 2021. 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 China. 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. 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?
Results are not available in the source record.
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?
the occurrence of complicated twin pregnancy as assessed by prenatal ultrasound (time frame: up to two years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 8 Mar 2021.