Trials Flashcards
Truffle trial
When +who
Method
Population
Intervention
Outcome
Findings
Controversy
Lancet 2015
European unblinded multicentre randomized
Trial of Umbilical and Fetal Flow in Europe
Singleton 26-32/40 with very preterm FGR + raised UAPI
Intention to treat
Decision to deliver based on DV early DV late or reduced CTG STV
Found stat insignificant increase in mortality but better neurological outcomes at 2 years. Noted grit study
Noted safety net of severe ctg changes required immediate delivery. 511 woman.
Magpie trial
Method/type
Who
When
Intervention
Outcome
Findings
Controversy
2002
Random single blinded multi centre international trial 33 countries
>10000 women with pet d uncertainty re mgs04
Intention to treat analysis, stopped because such a clear benefit
Significantly fewer fits 11 per 1000 fewer and reduction in maternal death. Nil substantive harmful effects on mother or child, 1/4 will have side effects
Clasp
What/abstract/outcome
Intervention
Population/time
Outcome
Effect on clinical practice
Low dose aspirin for prevention and treatment of pet for 9364 women
Multicentre rct 60mg aspirin vs placebo, double blinded
As pet associated with intravascular production of prostacyclin + thromboxane- early activation of clotting system/plt
213 centres 5 years 12 and 32 weeks
Found small increase in duration of pregnancy and reduction in severity of pet- most with women with higher risk of early pet
ACTORDS trial
Intervention
Population
Theory
Method
Outcome
Impact on clinical practice
Neonatal rds after repeat exposure to antenatal steroids rct
982 women hospital <32 weeks saline or celestone im x2 rct
Fewer had rds 33 to 41, fewer had severe lung disease, less o2, weight lower but at discharge same
Australasian!!! 23 hospitals!
ACHOIS Australian carbohydrate intolerance study in preg women
Treatment of gdm
When
Q
Method
Population
Outcome
Effect on clinical practice
?treatment of gdm reduces perinatal complications
Ogtt 18 areas - Australia + uk 7.8, 7.8-11
Primary outcomes: IOL, CS, shoulder dystocia,
Nnt 34 to reduce serious perinatal outcome. CS similar, IOL higher in gdm intervention, less lga
Actords
Full name
Australasian collaborative trial of repeat doses of steroids, neonatal rds post repeat exposure to antenatal corticosteroids
Actord which author, journal and when
Crowther lancet 2006
Actords
Aim, design, setting, participants
Whether repeat corticosteroids given to women at risk of PTB can reduce neonatal morbidity without harm
RCT
23 hospital Aus NZ
Mums who risk of PTB <32/40 7 or more days post first steroid course- 1,2 or 3 pregnancies
