Postpartum Hemorrhage Clinical Trial
— SERENEOfficial title:
Clinical Trial Designed to Assess the Safety and Effectiveness of the KOKO™ Device In Treating Primary Abnormal Postpartum Uterine Bleeding ("APUB") or Hemorrhage ("PPH")
Verified date | June 2024 |
Source | KOKO Medical Inc. |
Contact | Cathy Unruh |
Phone | 610-215-2011 |
cathyu[@]kokomed.com | |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of this study is to evaluate the safety and effectiveness of the KOKO™ device in the control and reduction of primary abnormal postpartum uterine bleeding or hemorrhage.
Status | Not yet recruiting |
Enrollment | 52 |
Est. completion date | July 30, 2025 |
Est. primary completion date | June 30, 2025 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Adult Female, 18 years of age or older at time of consent. - Subject is able to understand and provide informed consent to participate in the study. - Diagnosis of abnormal postpartum uterine bleeding (500 - 999 ml for vaginal birth) or postpartum hemorrhage (1000 - 1500 ml for vaginal or Cesarean birth) with suspected atony within 24 hours after vaginal or cesarean birth. - EBL, to be determined when investigator is ready to have the KOKO packaging opened: Vaginal birth: 500 - 1500 ml EBL or Cesarean birth: 1000 - 1500 ml EBL. - Failed first - line intervention of uterotonics and uterine massage/bimanual uterine massage to stop bleeding. Note: Uterotonic administration may continue concomitant with and post KOKO use. Exclusion Criteria: - EBL >1500ml, to be determined when investigator is ready to have the KOKO packaging opened. - Delivery at a gestational age < 34 weeks or, if multiples, uterus is judged <34 weeks size. - For cesarean births: Cervix < 2.5 cm dilated before use of KOKO. - Abnormal postpartum uterine bleeding or hemorrhage that the investigator determines to require more aggressive treatment, including any of the following: 1. hysterectomy; 2. B-lynch suture; 3. uterine artery embolization or ligation; 4. hypogastric ligation. - Known uterine anomaly. - Ongoing intrauterine pregnancy. - Placental abnormality including any of the following: 1. known placenta accreta; 2. retained placenta with known risk factors for placenta accreta (e.g., history of prior uterine surgery, including prior cesarean and placenta previa); 3. retained placenta without easy manual removal. - Known uterine rupture. - Unresolved uterine inversion. - Subject has undergone intrauterine balloon therapy, uterine packing or use of other negative pressure system(s) for tamponade treatment of this episode of abnormal postpartum uterine bleeding or hemorrhage prior to use of the KOKO™ device. - Current cervical cancer. - Current purulent infection of vagina, cervix, uterus. - Diagnosis of coagulopathy. |
Country | Name | City | State |
---|---|---|---|
United States | Cleveland Clinic (Fairview) | Cleveland | Ohio |
United States | MetroHealth | Cleveland | Ohio |
United States | The Ohio State University | Columbus | Ohio |
United States | Ochsner Baptist | New Orleans | Louisiana |
United States | New York-Presbyterian Hospital (NYPH)/Columbia University Irving Medical Center (CUIMC) | New York | New York |
United States | Christiana Care | Newark | Delaware |
United States | University of Utah | Salt Lake City | Utah |
Lead Sponsor | Collaborator |
---|---|
KOKO Medical Inc. |
United States,
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Carroli G, Cuesta C, Abalos E, Gulmezoglu AM. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2008 Dec;22(6):999-1012. doi: 10.1016/j.bpobgyn.2008.08.004. Epub 2008 Sep 25. — View Citation
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Kramer MS, Dahhou M, Vallerand D, Liston R, Joseph KS. Risk factors for postpartum hemorrhage: can we explain the recent temporal increase? J Obstet Gynaecol Can. 2011 Aug;33(8):810-819. doi: 10.1016/S1701-2163(16)34984-2. — View Citation
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Suarez S, Conde-Agudelo A, Borovac-Pinheiro A, Suarez-Rebling D, Eckardt M, Theron G, Burke TF. Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020 Apr;222(4):293.e1-293.e52. doi: 10.1016/j.ajog.2019.11.1287. Epub 2020 Jan 6. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Efficacy: Rate of Participants With Cessation of Abnormal Postpartum Uterine Bleeding or Hemorrhaging | Control of postpartum hemorrhage, defined as the avoidance of non-surgical, second line or surgical intervention to control abnormal postpartum uterine bleeding or hemorrhage after the use of the KOKO device. | 24 Hrs | |
Primary | Safety: Incidence, Severity and Seriousness of Device-related Adverse Events Experienced by Participants. | Incidence (i.e., rate or number of participants), severity and seriousness of device-related Adverse Events experienced by participants will be documented during the course of the study. | 6 weeks | |
Secondary | Time to control abnormal postpartum uterine bleeding or hemorrhage | Time from start of treatment to control of bleeding per protocol | 24 Hrs | |
Secondary | Rate of non-surgical or surgical procedures after KOKO use | Rate of non-surgical or surgical procedures required to control abnormal postpartum uterine bleeding or hemorrhage after KOKO use | 24 Hrs | |
Secondary | Transfusion rate and units | Rate of blood product transfusion required after KOKO use, and number of transfusions units administered | 24 Hrs through discharge | |
Secondary | KOKO Device Usability | Clinician reported assessment of KOKO device usability | 24 Hrs |
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