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The overall aim of this research proposal is to explore the feasibility and acceptability of home antenatal maternal-fetal monitoring technology within a high-risk pregnancy group. The investigators hypothesise that home monitoring is feasible and acceptable to both pregnant women and HCPs.
50 women from a single site will be recruited to use a home cardiotocography (CTG) device alongside routine antenatal care. Participants will use this device once a week, for an hour at a time, for up to 6 weeks or until delivery. The primary outcome is 20 minutes of continuous monitoring. Additional outcomes assess acceptability, adherence and safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Home antenatal CTG monitoring | Experimental | Participants will be asked to use the remote monitoring devices one a week for a 1 hour each time for up to 6 weeks or until delivery. Participants are eligible if they are aged 18 over over, 32+0 gestation onwards, singleton pregnancy, able to speak English and have at least one of 6 high-risk pregnancy conditions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pregnabit Pro device and PregnaOne platform | Device | Remote CTG device and online dashboard for remote pregnancy care |
|
| Measure | Description | Time Frame |
|---|---|---|
| The number of participants that produce interpretable antenatal maternal-fetal monitoring cardiotocogram (CTG) traces for each episode of intermittent home monitoring. | Completion of an at least 20 minutes of uninterrupted interpretable fetal heart recording which has computerised capability. This will be defined as a percentage derived from the number of monitoring episodes achieving the primary outcome divided by the total number of monitoring episodes. | Through study completion, an average of 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| The number of participants completing the full schedule of home maternal-fetal monitoring episodes. | Determined as the median number of monitoring episodes completed. | Through study completion, an average of 9 months |
| The number of women approached who agreed to participate within the study. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jack Hamer, MBChB | Contact | 0121 472 1377 | jack.hamer1@nhs.net |
| Name | Affiliation | Role |
|---|---|---|
| Jack Hamer, MBChB | Birmingham Women's and Children's NHS Foundation Trust | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Birmingham Women's and Children's NHS Foundation Trust | Recruiting | Birmingham | B152TG | United Kingdom |
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50 participants split in one arm using the home CTG device. To detect a 20% difference in the mean anxiety scores pre- and post-study a sample size with a power of 90% (α =0.05), a sample size of 42 is required. 50 recruited women will allow for a 10% drop out rate.
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Number participants agreeing out of total women approached |
| Pre-intervention |
| What are the emotions of participants using home maternal-fetal monitoring. | Pre-intervention questionnaire using the accredited STAI anxiety questionnaire. | Pre-intervention |
| What are the emotions of participants using home maternal-fetal monitoring and is there an impact before and after a singular monitoring episode? | Questionnaire using the accredited STAI anxiety questionnaire at several time points whilst using the home monitoring device. Results compared pre and post monitoring episode to determine a if there is a discriminative impact on anxiety scores whilst using the home monitoring device. Results will be displayed graphically and compared using P value. | Through study completion, an average of 9 months |
| What are the emotions of participants using home maternal-fetal monitoring and was there any change from the beginning of the study. | Post-intervention questionnaire using the accredited STAI anxiety questionnaire. Results compared to the scores at the beginning of the study and demonstrated graphically and with a P value. | Immediately after the intervention |
| The usability of the remote monitoring device. | Assessed post study using the validated system usability scale scoring questionnaire. | Immediately after the end of the intervention |
| The number of participants with unexpected clinical outcomes detected whilst using home monitoring devices, which warrants patients to attend maternity triage for assessment and/or modification of ones antenatal care. | Number of unexpected outcomes requiring attendance to triage out of total number of monitoring episodes, presented as a percentage. | Through study completion, an average of 9 months |
| What are the views of participants regarding acceptability of home maternal-fetal monitoring. | Pre-intervention questionnaire using a 5 point Likert Scale (range from Strongly agree on the left, to strongly disagree on the right). No total score, each question individual and a tick box. | Pre-intervention |
| What are the views of participants regarding acceptability of home maternal-fetal monitoring. | Post-intervention questionnaire using a 5 point Likert Scale (range from Strongly agree on the left, to strongly disagree on the right). No total score, each question individual and a tick box. | Immediately after the intervention |
| The influence of participant demographics on achieving the primary outcome. | Analysis of factors which may influence achievement of the primary outcome. This includes ethnicity, education level, fetal presentation, parity. Presented as event numbers to calculated odds ratio's. | Through study completion, an average of 9 months |
| Determining participant adherence to commencing the monitoring episodes | Defined as the median time between when the participant commencing the monitoring episode and the time originally agreed to commence the monitoring episode previously jointly agreed between the researchers and participant. | Through study completion, an average of 9 months |
| The influence of fetal movements on achieving the primary outcome | Analysis of fetal movements during a monitoring episode and its influence on the primary outcome. Number of movements in the group achieving primary outcome compared to the group not achieving the primary outcome will be compared using the student T test. | Through study completion, an average of 9 months |