Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04350632
Other study ID # 2020-A00762-37
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date July 7, 2020
Est. completion date October 14, 2021

Study information

Verified date April 2021
Source Poitiers University Hospital
Contact Bertrand GACHON, MD, PhD student
Phone +33 5 49 44 39 45
Email bertrand.gachon@chu-poitiers.fr
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The risk prediction of obstetric anal sphincter injury couyl be optimized by considering pregnant women's anal sphincter intrinsic viscoelastic properties. Shear wave elastography is a new technology that allowed an in vivo assessment of viscoelastic properties of tissues such as muscles. The main endpoint of this study is to assess the intra-observer and the inter-observer reproducibility of a the external anal sphincter assessment using shear wave elastography in term pregnant women.


Description:

Investigations Assessment of the external anal sphincter viscoelastic properties using shear wave elastography technology using a transperineal approach in term pregnant women in two visits (the 1st one with only one observer and the second one with two observers) Follow up Prospective study including nulliparous term pregnant women with 2 visits planned, spaced at least by 12 hours and, for the most, 7 days. Primary outcome: The mean value of shear modulus measures in the external anal sphincter for the three considered conditions (rest, Valsalva maneuver and contraction) at each visit and for each observer with a calculation of Intraclass Correlation Coefficient and Variation Coefficient. Secondary outcomes: The secondary outcomes will be the percentage of completed procedure (ability to see the external sphincter and to obtain a measure of the shear modulus), the existence of a perineal tear according the RCOG-OMS classification and the answer to an acceptability question. Study design: Prospective monocentric study including nulliparous term pregnant women with two visits spaced of at least 12 hours and, for the most, 7 days. Interventions: Assessment of the external anal sphincter viscoelastic properties using shear wave elastography technology - Women in lithotomy position with an empty bladder - The linear probe is applied on transversal plane on the perineal with a transperineal approach - The external anal sphincter will be identified in 2D ultrasound using a SL 18-5 linear probe - Viscoelastic properties of the muscle will be assessed by measuring the shear modulus at rest, Valsalva maneuver and contraction - Exactly the same investigations will be performed for the two visits planned in the protocol. In the first visit, it will be one single observer and for the second it will be 2 observers. - Data about the mode of delivery and the occurrence of OASI will be collected into women's medical file Number of subjects: 40 volunteers pregnant women are planned for this research Statistical analysis: The number of successful procedures will be reported as effectives and percentages. Reproducibility will be reported by calculating the coefficient of variation and the intraclass correlation coefficient. The level of significance will be considered for p<0.05 Conditions : Obstetric anal sphincter injury Keywords: OASI; childbirth; perineal traumatism; delivery; biomechanics; shear wave elastography


Recruitment information / eligibility

Status Recruiting
Enrollment 40
Est. completion date October 14, 2021
Est. primary completion date October 7, 2021
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 18 Years and older
Eligibility Inclusion Criteria: - pregnant women aged of 18 years or more - 37 weeks or more of pregnancy - without any previous delivery (vaginal or cesarean delivery) - body mass index < 35Kg.m-2 - without history of Crohn's disease - without history of peri anal surgery - without any proctologic disease - without any muscular chronic disease - having a normal pregnancy - without any untreated psychiatric disorders - without any judicial protection - affiliated to a health insurance Exclusion Criteria: - pregnant women younger than 18 years old - obstetric term inferior than 37 weeks - history of vaginal and/or cesarean delivery - body mass index of 35Kg.m-2 or more - history of Crohn's disease - history of peri anal surgery - proctologic disease - muscular chronic disease - pathological pregnancy (intrauterine growth restriction, pre eclampsia etc..) - untreated psychiatric disorders - women under judicial protection - women without affiliated to a health insurance

Study Design


Related Conditions & MeSH terms


Intervention

Diagnostic Test:
Shear wave elastography assessment of the external anal sphincter
Assessment of the external anal sphincter viscoelastic properties using shear wave elastography technology Women in lithotomy position with an empty bladder The linear probe is applied on transversal plane on the perineal with a transperineal approach The external anal sphincter will be identified in 2D ultrasound using a SL 18-5 linear probe Viscoelastic properties of the muscle will be assessed by measuring the shear modulus at rest, Valsalva maneuver and contraction Exactly the same investigations will be performed for the two visits planned in the protocol. In the first visit, it will be one single observer and for the second it will be 2 observers. Data about the mode of delivery and the occurrence of OASI will be collected into women's medical fil

Locations

Country Name City State
France CHU de Poitiers Poitiers

Sponsors (1)

Lead Sponsor Collaborator
Poitiers University Hospital

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary value of shear modulus measures in the external anal sphincter for each visit with the calculation of the ICC The mean value of shear modulus measures in the external anal sphincter for the three considered conditions (rest, Valsalva maneuver and contraction) at each visit and for each observer with a calculation of Intraclass Correlation Coefficient up to seven days
Primary value of shear modulus measures in the external anal sphincter for each visit with the calculation of the coefficent of variation The mean value of shear modulus measures in the external anal sphincter for the three considered conditions (rest, Valsalva maneuver and contraction) at each visit and for each observer with a calculation of Variation Coefficient up to seven days
Secondary Perineal tears at childbirth the existence of a perineal tear according the RCOG-OMS classification up to 4 weeks
Secondary Feasibility of the assessment of the external anal sphincter: percentage of completed procedure percentage of completed procedure (ability to identify the extarnal anal sphincter and to perform a shear wave elastography assessment) up to seven days
Secondary Acceptability of the procedure: question with a scale answer to the acceptability question with a scale from 0 to ten up to seven days
See also
  Status Clinical Trial Phase
Enrolling by invitation NCT05832268 - Pelvic Floor Function After Obstetric Injury to the Anal Sphincter
Completed NCT04181840 - Impedance Spectroscopy for Obstetric Anal Sphincter Injuries Detection N/A
Completed NCT04903977 - Detection of Obstetric Anal Sphincter Injuries With ONIRY Device N/A
Recruiting NCT06143072 - CArE for OAsI Study: Care Pathways and Anorectal Evaluation for OASI Associated Incontinence
Completed NCT03769792 - Impedance Spectroscopy in Detection of Obstetric Anal Sphincter Injuries N/A
Completed NCT03912142 - Diagnosis of Obstetric Anal Sphincter Injuries (OASIs) Using Transperineal Ultrasound Scan (TPUS)
Completed NCT02701413 - Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery N/A
Completed NCT02655900 - Use of 3D Ultrasound to Predict Anal Sphincter Defects N/A
Completed NCT05898945 - Primary Repair of Obstetric Anal Sphincter Injuries (OASIS) by Surgeons (PROS Study)
Recruiting NCT04446780 - Mediolateral Episiotomy and Obstetric Anal Sphincter Injuries in Instrumental Delivery