
Search Clinical Trials
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Thoracic-Lumbar Arthrodesis- Implanet Jazz
Francis Farhadi
Spondylolisthesis
Spinal Stenosis
Degenerative Disease
Establish a data repository of patients who have undergone single, two-, or three-level
lumbar instrumented arthrodesis procedures supplemented by the Implanet Jazz System. expand
Establish a data repository of patients who have undergone single, two-, or three-level lumbar instrumented arthrodesis procedures supplemented by the Implanet Jazz System. Type: Observational [Patient Registry] Start Date: Feb 2022 |
Ketamine in Patients Undergoing TEVAR Procedures Receiving NCI
Sam Tyagi
Descending Aortic Dissection
Postoperative Pain
Thoracoabdominal Aortic Aneurysm
The objective of this study is to identify the opioid-sparing effects, and pain-reduction
potential of low dose, sub-dissociative ketamine on patients undergoing thoracic
endovascular aortic repair (TEVAR) procedures receiving naloxone continuous infusion
(NCI). expand
The objective of this study is to identify the opioid-sparing effects, and pain-reduction potential of low dose, sub-dissociative ketamine on patients undergoing thoracic endovascular aortic repair (TEVAR) procedures receiving naloxone continuous infusion (NCI). Type: Interventional Start Date: Dec 2020 |
Healthy Recovery After Trauma Study
Christal L Badour
Stress Disorders, Post-Traumatic
Shame
Guilt
Sexual Assault and Rape
Mental contamination-an internal experience of dirtiness evoked in the absence of
physical contact with an external source-has been linked to the development and
maintenance of posttraumatic stress disorder (PTSD) following exposure to sexual abuse or
assault (Adams et al., 2014; Badour et al., 2011 expand
Mental contamination-an internal experience of dirtiness evoked in the absence of physical contact with an external source-has been linked to the development and maintenance of posttraumatic stress disorder (PTSD) following exposure to sexual abuse or assault (Adams et al., 2014; Badour et al., 2013; Brake et al., 2017). Mental contamination has been associated with greater PTSD severity (Rachman et al., 2015) and higher elevations in specific PTSD symptom clusters (particularly those of intrusive reexperiencing, negative cognitions/mood, and arousal/reactivity; Brake et al., 2019; Fergus & Bardeen, 2016). Additionally, trauma-related mental contamination has been linked to a number of negative posttraumatic emotions such as shame, guilt, disgust, and anger (Fairbrother & Rachman, 2004; Radomsky & Elliott, 2009) Despite clear and consistent links between mental contamination and problematic posttraumatic outcomes following sexual trauma, there is a dearth of research investigating how existing or promising new interventions for PTSD impact mental contamination. Cognitive Processing Therapy (CPT) is an efficacious and effective 12-session manualized cognitive-behavioral intervention for PTSD that is considered a gold-standard empirically-supported treatment for PTSD that is recommended by the American Psychological Association (APA, 2017). In addition to PTSD symptom improvement, CPT has also demonstrated benefit for improving feelings of shame and guilt, which are often seen among individuals with trauma-related mental contamination (Nishith et al., 2005; Resick et al., 2002, 2008). Cognitive reappraisal, a primary technique employed in CPT, involves challenging one's view of an emotionally-eliciting situation to alter its emotional impact (Gross & John, 2003). However, some investigators have suggested that cognitive reappraisal may be less effective in targeting moral emotions such as shame, guilt, and self-disgust that are based on an individual's standards and virtues (Finlay, 2015). Self-compassion (SC; i.e., self-directed care and kindness; forgiveness; and feelings of common humanity; Neff, 2003) has been proposed as an alternative method for addressing trauma-related shame and preliminary evidence suggests a 6-session self-compassion intervention may have benefit for reducing both PTSD symptoms and trauma-related shame (Au et al., 2017). Given the centrality of shame, guilt, and self-disgust to the experience of mental contamination, and the fact that mental contamination often arises in response to experiences involving moral violation or betrayal (Millar et al., 2016; Rachman, 2010), a SC intervention for PTSD may also offer promise as a standalone or adjunctive intervention for reducing trauma-related mental contamination. A test of these interventions for their impact on reducing trauma-related mental contamination is needed. The current study will use Single Case Experimental Design to isolate and evaluate the effects of CPT and SC in reducing both PTSD symptoms and trauma-related mental contamination among individuals with PTSD resulting from sexual trauma. Aims: 1) explore whether participants demonstrate reductions in mental contamination and PTSD symptoms in response to 12-sessions of CPT or 6-sessions of a SC intervention; 2) evaluate whether presentation of either treatment first yields differences in symptom reduction for PTSD and/or mental contamination symptoms; 3) evaluate whether the addition of the alternative module will enhance reductions in PTSD symptoms and mental contamination; 4) evaluate if such reductions are maintained during follow-up. Visual inspection analysis and statistical methods will be used to draw conclusions regarding the effects of the interventions on PTSD symptoms and mental contamination. Type: Interventional Start Date: Sep 2020 |
Optimizing Pharmacologic Treatment for Neonatal Opioid Withdrawal Syndrome (OPTimize NOW): A Sympto1
HELP for NOWS Consortium
Neonatal Opiate Withdrawal Syndrome
This clinical trial will help us learn more about how to best care for babies with
Neonatal Opioid Withdrawal Syndrome, also called NOWS. Babies with NOWS often have
tremors, a hard time sleeping, excessive crying, and trouble feeding. Some babies that
have NOWS need medicine. Doctors have two ways1 expand
This clinical trial will help us learn more about how to best care for babies with Neonatal Opioid Withdrawal Syndrome, also called NOWS. Babies with NOWS often have tremors, a hard time sleeping, excessive crying, and trouble feeding. Some babies that have NOWS need medicine. Doctors have two ways of providing medicine that are widely used today: 1. Scheduled opioid taper approach. The baby gets medicine at regular times. As symptoms get better, the amount of medicine the baby gets decreases until the baby no longer needs medicine. This is called a medicine taper. 2. Symptom-based approach. The baby will only get medicine when they show signs of NOWS, instead of at regular times. If the baby is showing no signs of NOWS, no medicine will be given. We are doing the OPTimize NOW study to figure out the best way to give medicine to babies with NOWS. Type: Interventional Start Date: Mar 2024 |
Precision Lung Cancer Survivorship Care Intervention
Jerod L Stapleton, PhD
Lung Cancer
Pulmonary Neoplasm
Neoplasms, Lung
Neoplasms, Pulmonary
Neoplasm, Pulmonary
The overarching goal of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care
program is to reduce the burden of lung cancer by offering an innovative survivorship
care approach that improves lung cancer quality of life, overcomes lung cancer stigma,
and helps survivors engage with care. T1 expand
The overarching goal of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care program is to reduce the burden of lung cancer by offering an innovative survivorship care approach that improves lung cancer quality of life, overcomes lung cancer stigma, and helps survivors engage with care. The project involves a two-group parallel randomized clinical trial comparing the impact of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care program (KLCLCSC) among lung cancer survivors (N=300) against an enhanced usual care condition (bibliotherapy+assessment) on quality of life outcomes. Type: Interventional Start Date: Aug 2024 |
Post Approval Study - Evaluate the Long-Term Safety and Effectiveness of the WEB Device
Microvention-Terumo, Inc.
Wide Neck Bifurcation Intracranial Aneurysms
A prospective, multicenter, single arm, interventional study. The target patient
population for this study are adult subjects with WNBAs of the anterior and posterior
intracranial circulation. The primary effectiveness outcome of the study is adequate
intracranial aneurysm occlusion on the 1 year a1 expand
A prospective, multicenter, single arm, interventional study. The target patient population for this study are adult subjects with WNBAs of the anterior and posterior intracranial circulation. The primary effectiveness outcome of the study is adequate intracranial aneurysm occlusion on the 1 year angiogram as adjudicated by a core laboratory. Type: Interventional Start Date: Aug 2022 |
Topical Antibiotic Therapy to Reduce Infection After Operative Treatment of Fractures At High Risk1
Major Extremity Trauma Research Consortium
Post Operative Surgical Site Infection
The overall objective is to compare the effect of Vancomycin and Tobramycin powder
combined (treatment) to Vancomycin powder (control) in the reduction of post-fixation
infections of tibial plateau and tibial pilon fractures at high risk of infection
(collectively considered the "study injuries"). expand
The overall objective is to compare the effect of Vancomycin and Tobramycin powder combined (treatment) to Vancomycin powder (control) in the reduction of post-fixation infections of tibial plateau and tibial pilon fractures at high risk of infection (collectively considered the "study injuries"). Type: Interventional Start Date: May 2021 |
Neuroblastoma Maintenance Therapy Trial
Giselle Sholler
Neuroblastoma
Difluoromethylornithine (DFMO) will be used in an open label, single agent, multicenter,
study for patients with neuroblastoma in remission. In this study subjects will receive
730 Days of oral difluoromethylornithine (DFMO) at a dose of 750 mg/m2 ± 250 mg/m2 BID
(strata 1, 2, 3, and 4) OR 2500 mg/1 expand
Difluoromethylornithine (DFMO) will be used in an open label, single agent, multicenter, study for patients with neuroblastoma in remission. In this study subjects will receive 730 Days of oral difluoromethylornithine (DFMO) at a dose of 750 mg/m2 ± 250 mg/m2 BID (strata 1, 2, 3, and 4) OR 2500 mg/m2 BID (stratum 1B) on each day of study. This study will focus on the use of DFMO in high risk neuroblastoma patients that are in remission as a strategy to prevent recurrence. Type: Interventional Start Date: Feb 2016 |
Rehabilitation Strategies to Improve Outcomes For Patients With a Lower Extremity Fracture
Brian W. Noehren
Femoral Fracture
Tibial Fractures
The purpose of this study is to evaluate speed high intensity interval training (HIIT)
walking program following an orthopedic trauma. expand
The purpose of this study is to evaluate speed high intensity interval training (HIIT) walking program following an orthopedic trauma. Type: Interventional Start Date: Mar 2022 |
Role of the Sympathetic Nervous System in Rosacea
Kristen Metzler-Wilson
Rosacea
Rosacea is a common skin disorder which causes facial redness and inflammation in about
16 million Americans, from an unknown cause. Many triggers of rosacea symptoms are
stressors that affect the sympathetic ("fight or flight") portion of the nervous system,
and a recent pilot study suggests there1 expand
Rosacea is a common skin disorder which causes facial redness and inflammation in about 16 million Americans, from an unknown cause. Many triggers of rosacea symptoms are stressors that affect the sympathetic ("fight or flight") portion of the nervous system, and a recent pilot study suggests there is sympathetic dysfunction in rosacea. This project will benefit patients, clinicians, and basic scientists by increasing our understanding of sympathetic nervous system involvement in rosacea symptoms in order to develop improved treatments for patients with rosacea. Type: Interventional Start Date: May 2019 |
A Research Study to Advance the CF Therapeutics Pipeline for People Without Modulators
Nicole Hamblett
Cystic Fibrosis
The REACH study is for people with CF who do not take cystic fibrosis transmembrane
conductance regulator (CFTR) modulators. The goal of the REACH study is to collect
research data, including health data and specimens, from people with CF who do not take
CFTR modulators. This data may be used to in1 expand
The REACH study is for people with CF who do not take cystic fibrosis transmembrane conductance regulator (CFTR) modulators. The goal of the REACH study is to collect research data, including health data and specimens, from people with CF who do not take CFTR modulators. This data may be used to inform CF research, help design CF clinical trials and support the development of new treatments for people with CF who do not take CFTR modulators. Another goal of this study is to learn about research involvement for people with CF who do not take CFTR modulators, engage them in research, and give them an opportunity to learn about what is involved in participating in a CF research study. Type: Observational Start Date: Sep 2024 |
Telehealth Delivered Physical Rehabilitation for an Ankle Sprain
Kyle Kosik
Ankle Sprains
Telerehabilitation
Analgesic, Opioid
Analgesics, Non-narcotic
Anti-Inflammatory Agents, Non-Steroidal
A vast majority (75-85%) of ankle sprain patients treated in emergency departments (ED)
receive pain medication and are not referred for physical rehabilitation. Therefore,
purpose of this study is to increase access to the standard of care for an ankle sprain
by provide patients with physical reha1 expand
A vast majority (75-85%) of ankle sprain patients treated in emergency departments (ED) receive pain medication and are not referred for physical rehabilitation. Therefore, purpose of this study is to increase access to the standard of care for an ankle sprain by provide patients with physical rehabilitation delivered through telehealth. The purpose of this study includes compare a 2-week telehealth intervention to the usual care for treating 1) subjective function; 2) physical impairments; 3) medication consumption; and 4) patient-perceived barriers. The central hypothesis is participants receiving the 2-week telehealth intervention will 1) have less pain and disability; 2) improve balance and ankle range of motion; 3) consume less medication; and 4) reports positive feedback compared to the usual care group. Type: Interventional Start Date: Jan 2021 |
Muscle Recovery After Critical Illness
Kirby Mayer
ICU Acquired Weakness
Post Intensive Care Unit Syndrome
Muscle Weakness
Critical Illness
The overarching goal of the proposed study is to determine the trajectories of physical
recovery and cellular markers involved with the underlying failure to recover muscle
after critical illness, while exploring which characteristics are associated with
sustained physical disability. This proposal1 expand
The overarching goal of the proposed study is to determine the trajectories of physical recovery and cellular markers involved with the underlying failure to recover muscle after critical illness, while exploring which characteristics are associated with sustained physical disability. This proposal will examine muscle pathophysiology carefully aligned with physical function outcomes in order to longitudinally assess the recovery, or failed recovery, of muscle function in participants after critical illness: 1. to examine the recovery of muscle and physical function in ICU survivors through longitudinal assessments 2. to investigate the underlying cellular markers and mechanisms of muscle recovery in ICU survivors 3. to determine which cellular markers contribute to physical disability in ICU survivors up to 1 year after hospital admission Type: Observational Start Date: Oct 2022 |
Person-Environment Fit for Persons With Dementia
Elizabeth K Rhodus
Dementia Alzheimers
Alzheimer Disease
This trial will assess feasibility of a non-pharmacological intervention for persons
living with Alzheimer's disease and related dementias (ADRD) to improve behavioral and
psychiatric symptoms of dementia and functional performance.
Using a two-arm, prospective randomized controlled trial, 38 dyad1 expand
This trial will assess feasibility of a non-pharmacological intervention for persons living with Alzheimer's disease and related dementias (ADRD) to improve behavioral and psychiatric symptoms of dementia and functional performance. Using a two-arm, prospective randomized controlled trial, 38 dyads (person with ADRD and caregiver) will complete an 8-week telehealth occupational therapy intervention provided via Zoom with caregivers and persons with dementia or receive an active control with 8 telehealth sessions to discuss publicly available caregiver education with a non-clinical research assistant. Type: Interventional Start Date: Jun 2023 |
Heart of the Family: A Cardiovascular Disease and Type 2 Diabetes Risk Reduction Intervention in Hi1
Gia Mudd
Diabetes Mellitus, Type 2
Cardiovascular Diseases
Rural populations in the U.S. are disproportionately burdened by cardiovascular disease
and type 2 diabetes. Lifestyle modification interventions are needed that support
long-term engagement in risk-reducing health behaviors. This trial will study the effects
of a family-focused, lifestyle interven1 expand
Rural populations in the U.S. are disproportionately burdened by cardiovascular disease and type 2 diabetes. Lifestyle modification interventions are needed that support long-term engagement in risk-reducing health behaviors. This trial will study the effects of a family-focused, lifestyle intervention that is culturally tailored for use with rural Hispanic and non-Hispanic adults. If successful, this community-based intervention has significant potential for broad dissemination to reduce cardiovascular disease and type 2 diabetes health disparities in rural U.S. communities. Type: Interventional Start Date: Sep 2021 |
Prospective Evaluation of Pathways for Preterm Birth
John O'Brien, MD
Preterm Birth
Cervix; Pregnancy
This is a single center, prospective cohort study of pregnant patients at high risk for
spontaneous preterm birth: patient's with history of spontaneous preterm birth, patient's
with a short cervix and patient's symptomatic for preterm birth will be included. A
control cohort of nulliparous patient1 expand
This is a single center, prospective cohort study of pregnant patients at high risk for spontaneous preterm birth: patient's with history of spontaneous preterm birth, patient's with a short cervix and patient's symptomatic for preterm birth will be included. A control cohort of nulliparous patients without a short cervix will be recruited to provide baseline data. Plan to enroll 240 patients identified through our ultrasound unit with goal of 60 patients in each group. Type: Observational Start Date: Feb 2022 |
LCH-IV, International Collaborative Treatment Protocol for Children and Adolescents With Langerhans1
North American Consortium for Histiocytosis
Langerhans Cell Histiocytosis
The LCH-IV is an international, multicenter, prospective clinical study for pediatric
Langerhans Cell Histiocytosis LCH (age < 18 years). expand
The LCH-IV is an international, multicenter, prospective clinical study for pediatric Langerhans Cell Histiocytosis LCH (age < 18 years). Type: Interventional Start Date: Nov 2016 |
RECOVER-SLEEP: Platform Protocol
Duke University
Long COVID
Long COVID-19
Hypersomnia
Sleep Disturbance
The platform protocol is designed to be flexible so that it is suitable for a range of
study settings and intervention types. Therefore, the platform protocol provides a
general protocol structure that can be shared by multiple interventions and allows
comparative analysis across the interventions.1 expand
The platform protocol is designed to be flexible so that it is suitable for a range of study settings and intervention types. Therefore, the platform protocol provides a general protocol structure that can be shared by multiple interventions and allows comparative analysis across the interventions. For example, objectives, measures, and endpoints are generalized in the platform protocol, but intervention-specific features are detailed in separate appendices. This platform protocol is a prospective, multi-center, multi-arm, randomized controlled platform trial evaluating potential interventions for PASC-mediated sleep disturbances. The hypothesis is that symptoms of sleep and circadian disorders that emerge in patients with PASC can be improved by phenotype-targeted interventions. Specific sleep and circadian disorders addressed in this protocol include sleep-related daytime impairment (referred to as hypersomnia) and complex PASC-related sleep disturbance (reflecting symptoms of insomnia and sleep-wake rhythm disturbance). Type: Interventional Start Date: Jul 2024 |
A Study Comparing Venetoclax and Azacitidine Plus Cusatuzumab to Venetoclax and Azacitidine in Newl1
OncoVerity, Inc.
Leukemia, Myeloid, Acute
The goal of this clinical trial is to learn if participants treated with the experimental
drug cusatuzumab added to venetoclax and azacitidine works to treat acute myeloid
leukemia (AML) compared to venetoclax and azacitidine. Venetoclax and azacitidine are
drugs commonly used to treat AML in patie1 expand
The goal of this clinical trial is to learn if participants treated with the experimental drug cusatuzumab added to venetoclax and azacitidine works to treat acute myeloid leukemia (AML) compared to venetoclax and azacitidine. Venetoclax and azacitidine are drugs commonly used to treat AML in patients that are unable to receive chemotherapy to treat AML. The main question the clinical trial aims to answer is does cusatuzumab added to venetoclax and azacitidine prolong the length of time participants live compared to venetoclax and azacitidine? Type: Interventional Start Date: Jul 2024 |
Comprehensive Connected Cancer Care (C4): Intervention Evaluation
Timothy Mullett
Cancer
Health Care Utilization
The C4 program aims to provide a multi-level intervention program (Patient Level,
Healthcare Team and Healthcare System Level) that improves the coordination of care with
supportive/ancillary care providers and community services through the use of patient
navigation and a digital needs assessment1 expand
The C4 program aims to provide a multi-level intervention program (Patient Level, Healthcare Team and Healthcare System Level) that improves the coordination of care with supportive/ancillary care providers and community services through the use of patient navigation and a digital needs assessment and a closed-loop referral system and improves patient-centered communication and engagement in care through skills training for the healthcare team and provision of culturally appropriate patient educational tools and resources. The program components incorporate three areas that are critical to improving patient-centered care: coordination of care, patient-centered communication and engagement, and psychosocial care and other supportive services. Type: Interventional Start Date: Feb 2024 |
Pathways, a Hope Intervention to Support Personal Goal Pursuit, Mental Health, and Quality of Life1
Laurie McLouth
Lung Cancer
This study will compare the effects of a brief supportive intervention, called Pathways,
against enhanced usual care on the mental health and quality of life of people undergoing
treatment for advanced lung cancer. Patients will complete baseline survey measures and
be randomized to intervention. S1 expand
This study will compare the effects of a brief supportive intervention, called Pathways, against enhanced usual care on the mental health and quality of life of people undergoing treatment for advanced lung cancer. Patients will complete baseline survey measures and be randomized to intervention. Survey measures will be collected again mid-intervention, post-intervention and at 6- and 12-week follow-up, with analyses focused on changes pre- to post-intervention. Type: Interventional Start Date: Nov 2023 |
Randomized Controlled Trial of a Single-session Mechanism-focused Intervention for Suicidal Thought1
Shannon E. Sauer-Zavala
Suicidal Ideation
Hopelessness
Wish to Live
Wish to Die
Across multiple models of suicide risk, hopelessness and perceptions of social
relatedness (i.e., lack of social connection/thwarted belongingness, perceived
burdensomeness) have emerged as candidate mechanisms that maintain STBs. Although these
mechanisms have garnered strong empirical support in1 expand
Across multiple models of suicide risk, hopelessness and perceptions of social relatedness (i.e., lack of social connection/thwarted belongingness, perceived burdensomeness) have emerged as candidate mechanisms that maintain STBs. Although these mechanisms have garnered strong empirical support in predicting STBs, there has been virtually no integration with interventions aimed for individuals at acute risk for suicide. Thus, the overarching goal of the present proposal is to evaluate a mechanism-focused intervention that explicitly targets two core mechanisms implicated in the maintenance of STBs: hopelessness and negative perceptions of social relatedness. Given that the period immediately following hospital discharge presents the highest risk for suicide attempts and up to 70% of patients admitted for a suicide attempt do not attend their first outpatient appointment, the intervention will be evaluated on an inpatient unit. Additionally, most of the extant interventions for STBs are administered across multiple sessions (i.e., 4 sessions and up to one year); however treatments of this length are unlikely to be feasible in acute care settings. Fortunately, very brief suicide prevention interventions, are effective in reducing future suicide attempts and increasing the likelihood of attending follow-up treatments. Additionally, single-session interventions (not suicide specific) have been shown to reduce hopelessness immediately and at a one-month follow-up. The present study is an RCT comparing a novel Single Session Mechanism Focused Intervention (SSMFI) for STBs to treatment-as-usual (TAU) on a psychiatric inpatient unit for patients admitted for suicidal ideation or attempt. The engagement of the putative processes (hopelessness and negative perceptions of social relatedness) that maintain STBs will be assessed, along with the feasibility and acceptability of SSMFI for STBs on an inpatient psychiatric unit. Type: Interventional Start Date: Oct 2024 |
A Study With Eptinezumab in Children and Adolescents (6 to 17 Years) With Chronic or Episodic Migra1
H. Lundbeck A/S
Migraine
The main goal of the study is to assess the long-term safety of eptinezumab on children
and adolescents ages 6 to 17 with chronic or episodic migraine. expand
The main goal of the study is to assess the long-term safety of eptinezumab on children and adolescents ages 6 to 17 with chronic or episodic migraine. Type: Interventional Start Date: Dec 2021 |
Study of Tirabrutinib (ONO-4059) in Patients With Primary Central Nervous System Lymphoma (PROSPECT1
Ono Pharmaceutical Co. Ltd
Refractory Primary Central Nervous System Lymphoma
Primary CNS Lymphoma
This study will evaluate the efficacy, safety, and pharmacokinetics of tirabrutinib
monotherapy in patients with relapsed or refractory PCNSL (Part A), and tirabrutinib in
combination with one of two different high dose methotrexate based regimens
(methotrexate/ temozolomide/rituximab or rituximab/1 expand
This study will evaluate the efficacy, safety, and pharmacokinetics of tirabrutinib monotherapy in patients with relapsed or refractory PCNSL (Part A), and tirabrutinib in combination with one of two different high dose methotrexate based regimens (methotrexate/ temozolomide/rituximab or rituximab/methotrexate/procarbazine/ vincristine) as first line therapy in patients with newly diagnosed, treatment naïve PCNSL (Part B) Type: Interventional Start Date: Dec 2021 |
Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly (STOP BL1
NYU Langone Health
AVB - Atrioventricular Block
Fetal AVB
Fetal complete (i.e., third degree, 3°) atrioventricular block (AVB), identified in the
2nd trimester of pregnancy in an otherwise normally developing heart, is almost
universally associated with maternal anti-Ro autoantibodies and results in death in a
fifth of cases. To date treatment of 3° AVB h1 expand
Fetal complete (i.e., third degree, 3°) atrioventricular block (AVB), identified in the 2nd trimester of pregnancy in an otherwise normally developing heart, is almost universally associated with maternal anti-Ro autoantibodies and results in death in a fifth of cases. To date treatment of 3° AVB has been ineffective in restoring normal rhythm (NR) which may be because current surveillance is limited to once- weekly fetal echocardiograms. It is hypothesized that there may be a vital transition period of several hours in which incomplete block (2° AVB) may be successfully treated avoiding fully advanced irreversible 3° AVB. To optimize the likelihood of timely detection of the transition period this study comprises three steps: 1) to risk stratify for high titer anti-Ro antibodies, which are necessary but not sufficient to develop fetal AVB; 2) to empower mothers to identify 2° AVB by using fetal heart rate and rhythm monitoring (FHRM) at home, and 3) to rapidly treat mothers who detect an abnormality by monitoring with an urgent echocardiogram that confirms 2° AVB with the hope of reversing 2° AVB before it becomes permanent (3° AVB). In addition, it will be determined if FHRM reduces the need for weekly echoes. Although mothers with low titer anti-Ro will not be continued in Step 2 and therefore not followed by FHRM, birth ECGs will be collected to confirm that low titer antibodies do not confer risk. It is anticipated that this study will provide an evidenced based surveillance strategy for those mothers at high risk of having a child with 3° AVB. Type: Interventional Start Date: Aug 2020 |
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