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Pregnancy RelatedNoviiNCT03156608

Novii External Fetal Monitoring Device

A study testing Novii ECG/EKG System and External fetal heart rate monitoring in people with Pregnancy Related and Fetal Distress, run by Intermountain Health Care, Inc. at 4 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will be conducted on women in labor. Fetal heart rate monitoring will be conducting using the Novii Fetal ECG/EMG system and comparing it to current standard of care external fetal heart rate and tocometry. Read more about this study

Who is it for?
Ages 18 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Pregnancy Related, Fetal Distress
What is being tested?
Novii ECG/EKG System and External fetal heart rate monitoring
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
218 participants
Where
4 sitesUnited States
Study dates
6 Mar 2017to 28 Jun 2017
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 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Pregnant women ≥ 18 years of age; gestational age ≥ 37 weeks
  • Singleton pregnancy.
  • These women will be those presenting to Labor and Delivery for one of the following:
  • Rule out labor
  • Spontaneous labor
  • Induction of labor

Who cannot join

  • Age < 18 years old; multiple gestation pregnancy; gestational age < 37 weeks
  • Fetal distress or vaginal bleeding prior to monitor placement
  • Previous cesarean section
  • Planned cesarean delivery.
  • Women who are enrolled in the study but have less than 1 hour of fetal heart rate monitoring after randomization will be excluded from analysis.

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • Intermountain Medical Center

    Murray, Utah, 84107

  • McKay-Dee Hospital

    Ogden, Utah, 84403

  • Utah Valley Hospital

    Provo, Utah, 84604

  • LDS Hospital

    Salt Lake City, Utah, 84143

Other trials in United States

About this study

Official title: Evaluation of the Novii External Fetal Monitoring Device: A Prospective, Randomized Comparison

This study will be conducted on women in labor. Fetal heart rate monitoring will be conducting using the Novii Fetal ECG/EMG system and comparing it to current standard of care external fetal heart rate and tocometry. These approaches will be compared with the respect to need for additional monitoring, amount of nursing intervention, cost and satisfaction of patients and healthcare providers.

Read the detailed description

Interpretation of fetal heart rate monitoring during labor is one of the most common procedures performed in the practice of obstetrics. Continuous monitoring of the fetal heart rate is used to identify infants at risk for hypoxic ischemic encephalopathy and allow for intervention to prevent this terrible complication. The quality of the fetal heart rate signal is critical for appropriate interpretation of the characteristics that identify risk.

This is a prospective, randomized pragmatic trial comparing the Novii Fetal ECG/EMG system to external fetal heart rate and tocometry (standard of care) for the amount of time of interpretable fetal heart rate during labor. Randomization will occur in blocks based on BMI to control for the potential effect of BMI.

Fetal heart rate tracings from both groups of women will be reviewed in a blinded fashion by experienced Maternal Fetal Medicine (MFM) physicians who will assess the tracing for quality and interpretability. In addition, both approaches will be compared with respect to the need for additional monitoring modalities, amount of nursing intervention, cost and satisfaction of the patients and healthcare providers.

Being tested
Novii ECG/EKG System, External fetal heart rate monitoring
Keywords
External Fetal Heart Rate Monitor, Fetal Heart Rate Monitor
Medical subject headings
Fetal Distress

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Novii ECG/EKG SystemDevice

    External fetal heart rate monitoring

  • External fetal heart rate monitoringDevice

    External fetal heart rate monitoring

Study groups in NCT03156608
Study groupRoleWhat they receive
Novii Device ECG/EMG SystemExperimentalThese patients will have the Novii ECG/EMG system placed throughout labor and delivery, unless a provider or investigator determines that a different device (internal or external) is necessary for a better signal.
Receives: Device: Novii ECG/EKG System
Standard of Care External MonitorActive comparatorA standard external monitor will be placed throughout labor and delivery, unless a provider or investigator determines that an internal device is necessary for a better signal.
Receives: Device: External fetal heart rate monitoring

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Amount of time in minutes with the interpretable fetal heart rate tracing during the course of labor.

    Quality of the fetal heart rate for each minute of tracing will be assessed visually by 2 or more blinded reviewers. For the purpose of this study, uninterpretable fetal heart rate will be defined as continuous fetal heart rate data with one or more of the following:

    1. Data is missing for more than 75% of the minute of tracing
    2. Artifact is present for more than 25% of the minute of tracing
    3. Missing data or artifact prevents determination of baseline rate
    4. > 15 seconds of continuous missing tracing
    5. Missing data is not continuous but is sufficiently frequent that the one minute segment of tracing could not be used to determine baseline rate

    The total number of interpretable minutes of fetal heart tracing and the percentage of time with interpretable fetal heart tracing over the course of labor (Number of minutes with interpretable FHR/Total number of minutes in labor) will be calculated for each patient.

    Measured: Time of randomization until time of delivery (up to 48 hours)

Secondary outcomes (29)
  1. Quality and interpretability of the FHT in ten minute segments

    1. Each 10 minute segment will be deemed to be interpretable if it meets all of the following criteria: i. Sufficient data are available to determine a baseline ii. Sufficient data are available to determine the variability of the tracing iii. Sufficient data are available to identify periodic changes in the tracing (e.g. accelerations, decelerations, etc) b. For each 10 minute segment that is called Uninterpretable, the reviewer will indicate the reason for this designation by selecting one of the following options: i. Poor signal quality due to missing data ii. Poor signal quality due to artifact iii. Adequate signal quality but intrinsic fetal heart rate makes interpretation impossible (e.g. marked variability, etc.)

    Measured: Time of randomization until time of delivery (up to 48 hours)

  2. Number and quality of uterine contractions in each 10 minute segment:

    The number of uterine contractions per segment will be recorded b. Signal quality (amount of missing data or artifact) will be recorded

    Measured: Time of randomization until time of delivery (up to 48 hours)

  3. Number and quality of uterine contractions in each 10 minute segment:

    Signal quality (amount of missing data or artifact) will be recorded

    Measured: Time of randomization until time of delivery (up to 48 hours)

  4. Number of times fetal heart rate monitor requires adjusting:

    Measured by recording the number of times the nurse must adjust the monitoring system to obtain interpretable tracing

    Measured: Time of randomization until time of delivery (up to 48 hours)

  5. Number of times fetal heart rate monitor requires adjusting:

    Number of times that hand holding of the monitor is required

    Measured: Time of randomization until time of delivery (up to 48 hours)

  6. Need for additional monitoring devices such as change from Novii to standard monitoring devices or the use of intrauterine pressure catheter or fetal scalp electrode:

    Need for additional monitoring devices will be determined by the clinical care team including attending physician and/or nurses based on clinical judgment

    Measured: Time of randomization until time of delivery (up to 48 hours)

  7. Need for additional monitoring devices such as change from Novii to standard monitoring devices or the use of intrauterine pressure catheter or fetal scalp electrode will be recorded by clinical care team:

    Reason 1: Poor signal quality - missing data Reason 2: Poor signal - artifact Reason 3: Need additional information (e.g. intrauterine pressure, etc.) Reason 4: Patient preference Reason 5: Provider preference

    Measured: Time of randomization until time of delivery (up to 48 hours)

  8. Need for additional monitoring devices such as change from Novii to standard monitoring devices or the use of intrauterine pressure catheter or fetal scalp electrode will be recorded by clinical care team:

    Reason 2: Poor signal - artifact Reason 3: Need additional information (e.g. intrauterine pressure, etc.) Reason 4: Patient preference Reason 5: Provider preference

    Measured: Time of randomization until time of delivery (up to 48 hours)

  9. Need for additional monitoring devices such as change from Novii to standard monitoring devices or the use of intrauterine pressure catheter or fetal scalp electrode will be recorded by clinical care team:

    Reason 3: Need additional information (e.g. intrauterine pressure, etc.) Reason 4: Patient preference Reason 5: Provider preference

    Measured: Time of randomization until time of delivery (up to 48 hours)

  10. Need for additional monitoring devices such as change from Novii to standard monitoring devices or the use of intrauterine pressure catheter or fetal scalp electrode will be recorded by clinical care team:

    Reason 4: Patient preference Reason 5: Provider preference

    Measured: Time of randomization until time of delivery (up to 48 hours)

  11. Need for additional monitoring devices such as change from Novii to standard monitoring devices or the use of intrauterine pressure catheter or fetal scalp electrode will be recorded by clinical care team:

    Reason 5: Provider preference

    Measured: Time of randomization until time of delivery (up to 48 hours)

  12. Nursing time required for care:

    We will record the amount of time that the nurses spend at the bedside to adjust the monitor b. Nurses will record the time and reasons that they enter the room

    Measured: Time of randomization until time of delivery (up to 48 hours)

  13. Nursing time required for care:

    Nurses will record the time and reasons that they enter the room

    Measured: Time of randomization until time of delivery (up to 48 hours)

  14. Overall cost of care:

    Total charge for care from admission to Labor and Delivery to transfer to postpartum care will be recorded for all patients

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  15. Overall cost of care:

    Delivery type and indication

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  16. Maternal outcomes - Length of labor

    Length of labor recorded

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  17. Maternal outcomes - Delivery type

    Type of delivery recorded (e.g., vaginal, cesarean section, etc.)

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  18. Maternal outcomes - Indication for forceps/vacuum extraction or cesarean section, if performed

    Clinical indication for forceps/vacuum extraction or cesarean section delivery

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  19. Maternal outcomes - Estimated blood loss

    Amount of blood loss (cc) recorded

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  20. Maternal outcomes - Presence and severity of perineal lacerations

    Lacerations and degree of laceration recorded

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  21. Maternal outcomes - Intra-amniotic infection (clinical chorioamnionitis or triple I)

    Infections documented

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  22. Maternal outcomes - Presence of clinical endometritis

    Endometritis diagnosis recorded

    Measured: Hospitalization for labor, delivery, and recovery - 2-4 days

  23. Neonatal outcomes - APGAR Scores

    APGAR scores recorded at 1 minute, 5 minutes, and 10 minutes

    Measured: Hospitalization after delivery - 2-4 days

  24. Neonatal outcomes - Need for ICU Admission

    Recorded NICU admission

    Measured: Hospitalization after delivery - 2-4 days

  25. Neonatal outcomes - Birthweight

    Infant birthweight (grams)

    Measured: Hospitalization after delivery - 2-4 days

  26. Neonatal outcomes - Neonatal Sex

    Neonatal sex recorded

    Measured: Hospitalization after delivery - 2-4 days

  27. Patient and provider satisfaction - Patient Survey

    Satisfaction survey completed by patient after delivery of infant

    Measured: Up to 7 days after delivery

  28. Patient and provider satisfaction - Nurse Survey

    Satisfaction survey completed by nurse attending labor/delivery after delivery of infant

    Measured: Up to 7 days after delivery

  29. Patient and provider satisfaction - Attending Physician/Midwife Survey

    Satisfaction survey completed by physician/midwife attending labor/delivery after delivery of infant

    Measured: Up to 7 days after delivery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 May 2017
  2. Study start6 Mar 2017
  3. Primary completion28 Jun 2017
  4. Study completion28 Jun 2017

Resources

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
Screening
Allocation
Randomised
Intervention model
Parallel groups
Model description
Women will be randomized to either standard monitoring with external Doppler and tocodynamometer or monitoring with the Novii Fetal ECG/EMG system using a computer generated randomization scheme through REDCap. Randomization will occur in blocks based on the subject's BMI. Women with a BMI \< 30 will be randomized separate from women with a BMI \> 30.
Masking
None (open label)
Enrolment
218 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03156608
Sponsor's protocol ID
1050411
Acronym
Novii
Status last verified
Oct 2017
First submitted
14 Mar 2017
Last updated
1 Nov 2017
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Publications

  • Bakker PC, Colenbrander GJ, Verstraeten AA, Van Geijn HP. The quality of intrapartum fetal heart rate monitoring. Eur J Obstet Gynecol Reprod Biol. 2004 Sep 10;116(1):22-7. doi: 10.1016/j.ejogrb.2004.01.001.

    PubMed 15294362
  • Cohen WR, Ommani S, Hassan S, Mirza FG, Solomon M, Brown R, Schifrin BS, Himsworth JM, Hayes-Gill BR. Accuracy and reliability of fetal heart rate monitoring using maternal abdominal surface electrodes. Acta Obstet Gynecol Scand. 2012 Nov;91(11):1306-13. doi: 10.1111/j.1600-0412.2012.01533.x. Epub 2012 Oct 19.

    PubMed 22924738
  • Cohen WR, Hayes-Gill B. Influence of maternal body mass index on accuracy and reliability of external fetal monitoring techniques. Acta Obstet Gynecol Scand. 2014 Jun;93(6):590-5. doi: 10.1111/aogs.12387. Epub 2014 Apr 30.

    PubMed 24684703
  • Dawes GS, Visser GH, Goodman JD, Redman CW. Numerical analysis of the human fetal heart rate: the quality of ultrasound records. Am J Obstet Gynecol. 1981 Sep 1;141(1):43-52. doi: 10.1016/0002-9378(81)90673-6.

    PubMed 7270621
  • Rooth G, Huch A, Huch R (1987) FIGO news: guidelines for the use of fetal monitoring. Int J Gynaecol Obstet 25:159-167

Questions about this trial

What is this clinical trial studying?

A study testing Novii ECG/EKG System and External fetal heart rate monitoring in people with Pregnancy Related and Fetal Distress, run by Intermountain Health Care, Inc. at 4 sites 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 6 inclusion and 5 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 1 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites 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. 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?

Amount of time in minutes with the interpretable fetal heart rate tracing during the course of labor. (time frame: Time of randomization until time of delivery (up to 48 hours)). 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 NCT03156608, which also lists 5 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 1 Nov 2017.

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