A Modernized Approach to Prenatal Care in Low Risk Women
| Status: | Completed |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | Any - 35 |
| Updated: | 4/2/2016 |
| Start Date: | July 2012 |
| End Date: | December 2013 |
| Contact: | Allan S Nadel, MD |
| Email: | anadel@partners.org |
| Phone: | 617 724 9014 |
The investigators plan to identify 80 pregnant women at low risk for obstetrical
complications and replace 4-5 routine third trimester visits with a structured program of
home weight, blood pressure and urine protein monitoring along with regular structured phone
interviews and a 28 week ultrasound. The investigators hypothesis is that this protocol is
both safe and acceptable.
complications and replace 4-5 routine third trimester visits with a structured program of
home weight, blood pressure and urine protein monitoring along with regular structured phone
interviews and a 28 week ultrasound. The investigators hypothesis is that this protocol is
both safe and acceptable.
Inclusion Criteria:
- Age < 35
- Doesn't live alone
- Current phone number
- Previous pregnancy
- No prior second trimester miscarriage/fetal loss after 13 weeks
- Previous delivery
- If yes, all had uncomplicated antepartum course
- All Deliveries > 37 weeks
- All birth weight > 2700 grams
- Maternal BMI between 18.5 and 30
- No chronic medical problems
- No current substance abuse
- Spontaneous conception
- No family history of pre-eclampsia
- Agrees to first trimester aneuploidy screening
Exclusion Criteria:
- Clinically significant abnormalities on routine physical exam or routine laboratory
results
- Multiple pregnancy
- Fetal abnormalities detected on either the 11-14 week or the 18 week ultrasound
including a nuchal translucency > 3 mm but not including second trimester markers for
aneuploidy or a low lying placenta
- A risk of fetal aneuploidy on first trimester screening > 1:300 PAPP-A < 5 %ile or
HCG < 1 %ile (abnormalities of these serum analytes routinely obtained as part of
aneuploidy screening are associated with an increased risk of adverse outcome)
- Elevated blood pressure (> 140/90),
- Cervical length < 3 cm at the 18 week ultrasound (which is associated with an
increased risk for preterm delivery).
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