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Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12617000417381
Ethics application status
Approved
Date submitted
20/02/2017
Date registered
23/03/2017
Date last updated
23/03/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
A Mother’s heart beats for two: to explore the current provision of evidence based practice, outcomes and ‘lived experience’ for women with cardiovascular disease during pregnancy.
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Scientific title
Retrospective longitudinal analysis of women with cardiac disease during pregnancy (2004-2014) to evaluate evidence based practice.
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Secondary ID [1]
291223
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nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Congenital heart disease
302143
0
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Ischaemic Heart Disease
302166
0
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Heart Failure
302369
0
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Arrhythmias
302370
0
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Rheumatic heart disease
302371
0
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Condition category
Condition code
Reproductive Health and Childbirth
301753
301753
0
0
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Childbirth and postnatal care
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Cardiovascular
301754
301754
0
0
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Coronary heart disease
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Cardiovascular
301755
301755
0
0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Retrospective Medical Records Review (MRR).
2 groups defined as :
1. Pre-existing cardiac condition
2. Newly acquired cardiac condition during course of pregnancy.
Observations will include documented pre-conception care i.e. clinical , medication ,physical and psychosocial assessment, relevant history, cardiac investigations, cardiac education, planned care and delivery management (evidence based practice), through the continuum of pregnancy.
In this study the continuum of care will be identified as the women’s journey in pregnancy through the healthcare system specifically , ante partium natal, intrapartium and post partium including any outpatient appointments with cardiac health practitioner. De identified data collected electronically via Auditmaker Data abstraction (collection) tool DAT that was developed based on SA perinatal guidelines. The tool was reviewed by experts and then pilot tested on 4 medical records.
The kind of data collected will include: static, evolving, or cumulative data and therefore the structure of the DAT will need be reflective of this information.
1.Static data: snapshot in time, i.e. demographic data ( PC , Age , ethnicity, )and medical history therefore reflected as single record ( past medical and obstetric history ).
2.Evolving data: the information is collected over time, repeated measurement, vital signs and daily medication orders and so may require single records /pages per time interval ( labour and delivery stages and medications required at birth)
3.Cumulative data: collected over time, but not linked to specific points in time ( 12 lead ECGS and echocardiograms required during course of pregnancy, number and follow up in post natal period .
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Intervention code [1]
297224
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
301154
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The reported number of medical record cases had documented evidence of routine appropriate education and preconception counselling had been undertaken in group 1 where women had a pre-existent congenital cardiac condition.
The group 2 where women had an acquired heart condition that was diagnosed or occurred during pregnancy that routine appropriate education and counselling was offered.
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Assessment method [1]
301154
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Timepoint [1]
301154
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Entry point 1 Pre-existing congenital condition pre-conception counselling prior to pregnancy.
Entry point 2 : Acquired heart condition from diagnosis and occurrence during pregnancy that includes first trimester through to postpartum.
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Primary outcome [2]
301171
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The reported number of medical record cases that had documented evidence of a patient and cardiac specific management strategy for treatment during pregnancy that defines labour , birth plan , and postpartum follow up and is available to the relevant multidisciplinary team members.
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Assessment method [2]
301171
0
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Timepoint [2]
301171
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The reported number of medical record cases had documented evidence of cardiac specific management strategy for treatment during pregnancy available for both groups in ante natal period .
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Primary outcome [3]
301172
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The reported number of medical record cases that had documented evidence of compliance / completion of perinatal guidelines for cardiac disease in pregnancy in both groups in relation to a patient and cardiac specific management strategy for treatment during pregnancy that defines labour , birth plan , and postpartum follow up and is available to the relevant multidisciplinary team members.
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Assessment method [3]
301172
0
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Timepoint [3]
301172
0
Documented evidence in medical records from antepartium through intrapartium to postpartum
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Secondary outcome [1]
331874
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The reported number of medical record cases where women were not identified with a cardiac condition in antepartium period however developed cardiac complications during intrapartium and post partium.
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Assessment method [1]
331874
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Timepoint [1]
331874
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Documented evidence in medical records from antepartium through intrapartium to postpartum.
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Eligibility
Key inclusion criteria
Patients will be identified as women with newly acquired heart disease or pre-existent congenital heart disease.
Women with the specific cardiac conditions will also be identified and documentation of the following : Ischemic heart disease( IHD) may include acute myocardial infarction (AMI) acute coronary syndrome (ACS) and angina, heart failure and cardiomyopathy, presence of arrhythmias during course of pregnancy and up to 12 months post delivery.
The MRR will include patients admitted to the three SA health metropolitan tertiary hospitals where management of women with cardiac disease in pregnancy occurs during 2004 and 2014
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Minimum age
17
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Medical records where patient is male gender.
Convenience sampling of the available medical records within the specific time frame with women identified with cardiac disease in pregnancy within the three SA health metropolitan tertiary hospitals where management of these women occurs only. Private hospital :-unable to access medical records.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
Descriptive statistics will be used to analyse data such as demographics collected from the MRR that describe and give meaning to quantitative data. Correlation will be used where appropriate to explore relationships between the variables (external and/or personal factors that influence variables between two principal groups of congenital heart disease and newly acquired heart disease). For example, Chi Square will be used to explore relationships between nominal data sets.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
17/12/2013
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Date of last participant enrolment
Anticipated
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Actual
24/06/2016
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Date of last data collection
Anticipated
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Actual
24/06/2016
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Sample size
Target
400
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Accrual to date
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Final
303
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
7512
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [2]
7513
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Lyell McEwin Hospital - Elizabeth Vale
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Recruitment hospital [3]
7514
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Womens and Childrens Hospital - North Adelaide
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Recruitment postcode(s) [1]
15336
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5042 - Bedford Park
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Recruitment postcode(s) [2]
15337
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5112 - Elizabeth Vale
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Recruitment postcode(s) [3]
15338
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5006 - North Adelaide
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Recruitment postcode(s) [4]
15339
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5112 - Elizabeth
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Funding & Sponsors
Funding source category [1]
295673
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University
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Name [1]
295673
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University of Adelaide
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Address [1]
295673
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The University of Adelaide
Adelaide Health & Medical Sciences Building,
Level 4
Adelaide SA 5005
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Country [1]
295673
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Australia
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Primary sponsor type
Individual
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Name
Sandra (Sindy) Kay Millington
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Address
The University of Adelaide
Adelaide Health & Medical Sciences Building,
Level 4
Adelaide SA 5005
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Country
Australia
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Secondary sponsor category [1]
294520
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None
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Name [1]
294520
0
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Address [1]
294520
0
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Country [1]
294520
0
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Other collaborator category [1]
279440
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University
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Name [1]
279440
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University of Adelaide
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Address [1]
279440
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The University of Adelaide
SA 5005
AUSTRALIA
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Country [1]
279440
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296987
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Human Reserach Ethics Committee (TQEH/LMH/MH)
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Ethics committee address [1]
296987
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Basil Hetzel Institute DX465101 The Queen Elizabeth Hospital 28 Woodville Road Woodville south SA 5011
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Ethics committee country [1]
296987
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Australia
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Date submitted for ethics approval [1]
296987
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04/09/2013
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Approval date [1]
296987
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04/11/2013
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Ethics approval number [1]
296987
0
HREC/13/TQEHLMH/226
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Summary
Brief summary
Title: A Mother’s heart beats for two: to explore the current provision of evidence based practice, outcomes and ‘lived experience’ for women with cardiovascular disease during pregnancy. Background: Although cardiac disease complicates approximately 1% to 3% of pregnancies it is responsible for 10% to 15% of maternal mortality. This rate is expected to increase in the current environment of elderly primigravida and increased obesity and diabetes in pregnancy. This study will evaluate the current care and outcomes for women with pre-existent or newly acquired cardiac disease during pregnancy. Methods: The proposed research will include phase 1 :-an analysis of the documented care and outcomes from a retrospective medical record review (MRR) for women with congenital and / or newly acquired heart disease during pregnancy and postnatal follow-up. Aims: 1. Describe the current the clinical course, appropriateness of care, referral and outcomes for these women and babies in relation to evidence based clinical practice guidelines 2. Identify gaps in the clinical management across the course of pregnancy, delivery and on-going care. 3. Elucidate and describe the experience of women with cardiac disease during pregnancy, delivery and on-going care. a. Articulate the difficulties encountered by women with cardiac disease in pregnancy. b. Identify elements that will facilitate improved clinical course and positive outcomes for women with cardiac disease in pregnancy Conclusion: The outcomes of this project will provide baseline data for further research, recommendations for practice change and strategies to improvement the uptake of evidence based guidelines.
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Trial website
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Trial related presentations / publications
articles submitted for peer review. Analysis in progress.
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Public notes
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Attachments [1]
1513
1513
0
0
/AnzctrAttachments/372394-HREC13TQEHLMH226finalapproval.pdf
(Ethics approval)
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Attachments [2]
1514
1514
0
0
/AnzctrAttachments/372394-HREC13TQEHLMH226 - 03.08.2015 Extension to Approval.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
72634
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Mrs Sandra (known as Sindy) Millington
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Address
72634
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Adelaide Nursing School
Faculty of Health & Medical Sciences
The University of Adelaide
Adelaide Health & Medical Sciences Building
Adelaide SA 5005
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Country
72634
0
Australia
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Phone
72634
0
+61 88313 2996
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Fax
72634
0
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Email
72634
0
[email protected]
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Contact person for public queries
Name
72635
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Judy Magarey
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Address
72635
0
Adelaide Nursing School
Faculty of Health & Medical Sciences
The University of Adelaide
Adelaide Health & Medical Sciences Building
Adelaide SA 5005
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Country
72635
0
Australia
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Phone
72635
0
+61 8 8313 6055
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Fax
72635
0
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Email
72635
0
[email protected]
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Contact person for scientific queries
Name
72636
0
Judy Magarey
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Address
72636
0
Adelaide Nursing School
Faculty of Health & Medical Sciences
The University of Adelaide
Adelaide Health & Medical Sciences Building
Adelaide SA 5005
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Country
72636
0
Australia
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Phone
72636
0
+61 8 8313 6055
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Fax
72636
0
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Email
72636
0
[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Plain language summary
No
As an increasing indirect global causal factor in ...
[
More Details
]
Study results article
Yes
March 17, 2020 Millington S, Arstall M, Dekker G...
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More Details
]
372394-(Uploaded-12-11-2021-13-43-56)-Journal results publication.pdf
Study results article
Yes
July 23 2021 Millington S, Edwards S, Clark RA, ...
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]
372394-(Uploaded-15-11-2021-11-42-53)-Journal results publication.pdf
Study results article
Yes
February 2019 Millington S, Magarey J, Dekker G...
[
More Details
]
372394-(Uploaded-12-11-2021-13-51-42)-Journal results publication.pdf
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The association between guidelines adherence and clinical outcomes during pregnancy in a cohort of women with cardiac co-morbidities.
2021
https://dx.doi.org/10.1371/journal.pone.0255070
N.B. These documents automatically identified may not have been verified by the study sponsor.
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