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Metadados | Descrição | Idioma |
---|---|---|
Autor(es): dc.contributor | Fernandes Figueira Inst | - |
Autor(es): dc.contributor | Universidade Estadual Paulista (Unesp) | - |
Autor(es): dc.contributor | Univ Pittsburgh | - |
Autor(es): dc.contributor | BC Childrens Hosp Res | - |
Autor(es): dc.contributor | Univ British Columbia | - |
Autor(es): dc.contributor | Univ Oxford | - |
Autor(es): dc.contributor | Kings Coll London | - |
Autor(es): dc.contributor | St Thomas Hosp | - |
Autor(es): dc.contributor | Univ London | - |
Autor(es): dc.creator | Bastos Dias, Marcos Augusto | - |
Autor(es): dc.creator | De Oliveira, Leandro [UNESP] | - |
Autor(es): dc.creator | Jeyabalan, Arundhanthi | - |
Autor(es): dc.creator | Payne, Beth | - |
Autor(es): dc.creator | Redman, Christopher W. | - |
Autor(es): dc.creator | Magee, Laura | - |
Autor(es): dc.creator | Poston, Lucilla | - |
Autor(es): dc.creator | Chappell, Lucy | - |
Autor(es): dc.creator | Seed, Paul | - |
Autor(es): dc.creator | von Dadelszen, Peter | - |
Autor(es): dc.creator | Roberts, James Michael | - |
Autor(es): dc.creator | PREPARE Res Grp | - |
Data de aceite: dc.date.accessioned | 2022-02-22T00:08:50Z | - |
Data de disponibilização: dc.date.available | 2022-02-22T00:08:50Z | - |
Data de envio: dc.date.issued | 2020-12-09 | - |
Data de envio: dc.date.issued | 2020-12-09 | - |
Data de envio: dc.date.issued | 2019-10-07 | - |
Fonte completa do material: dc.identifier | http://dx.doi.org/10.1186/s12884-019-2445-x | - |
Fonte completa do material: dc.identifier | http://hdl.handle.net/11449/196228 | - |
Fonte: dc.identifier.uri | http://educapes.capes.gov.br/handle/11449/196228 | - |
Descrição: dc.description | Background Preeclampsia (PE) is a major cause of short and long-term morbidity for affected infants, including consequences of fetal growth restriction and iatrogenic prematurity. In Brazil, this is a special problem as PE accounts for 18% of preterm births (PTB). In the PREPARE (Prematurity REduction by Pre-eclampsia cARE) study, we will test a novel system of integrated care based on risk stratification and knowledge transfer, to safely reduce PTB. Methods This is a stepped wedge cluster randomised trial that will include women with suspected or confirmed PE between 20 + 0 and 36 + 6 gestational weeks. All pregnant women presenting with these findings at seven tertiary centres in geographically dispersed sites, throughout Brazil, will be considered eligible and evaluated in terms of risk stratification at admission. At randomly allocated time points, sites will transition to risk stratification performed according to sFlt-1/PlGF (Roche Diagnostics) measurement and fullPIERS score with both results will be revealed to care providers. The healthcare providers of women stratified as low risk for adverse outcomes (sFlt-1/PlGF <= 38 AND fullPIERS< 10% risk) will receive the recommendation to defer delivery. sFlt-1/PlGF will be repeated once and fullPIERS score twice a week. Rates of prematurity due to preeclampsia before and after the intervention will be compared. Additionally, providers will receive an active program of knowledge transfer about WHO recommendations for preeclampsia, including recommendations regarding antenatal corticosteroids for foetal benefits, antihypertensive therapy and magnesium sulphate for seizure prophylaxis. This study will have 90% power to detect a reduction in PTB associated with PE from a population estimate of 1.5 to 1.0%, representing a 33% risk reduction, and 80% power to detect a reduction from 2.0 to 1.5% (25% risk reduction). The necessary number of patients recruited to achieve these results is 750. Adverse events, serious adverse events, both anticipated and unanticipated will be recorded. Discussion The PREPARE intervention expects to reduce PTB and improve care of women with PE without significant adverse side effects. If successful, this novel pathway of care is designed for rapid translation to healthcare throughout Brazil and may be transferrable to other low and middle income countries. | - |
Descrição: dc.description | Bill & Melinda Gates Foundation | - |
Descrição: dc.description | Fernandes Figueira Inst, Rio De Janeiro, Brazil | - |
Descrição: dc.description | Botucatu Sao Paulo State Univ, Med Sch, Obstet Dept, Botucatu, SP, Brazil | - |
Descrição: dc.description | Univ Pittsburgh, Dept Obstet & Gynecol, Pittsburgh, PA USA | - |
Descrição: dc.description | BC Childrens Hosp Res, Hlth Starts Theme, Vancouver, BC, Canada | - |
Descrição: dc.description | Univ British Columbia, Dept Anaesthesiol Pharmacol & Therapeut, Vancouver, BC, Canada | - |
Descrição: dc.description | Univ Oxford, Nuffield Dept Obstet & Gynaecol, Oxford, England | - |
Descrição: dc.description | Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, London, England | - |
Descrição: dc.description | Kings Coll London, Womens Hlth Acad Ctr, Div Womens Hlth, 10th Floor,North Wing, London, England | - |
Descrição: dc.description | St Thomas Hosp, Kings Hlth Partners, 10th Floor,North Wing, London, England | - |
Descrição: dc.description | Univ London, St Georges Hosp NHS Fdn Trust, London, England | - |
Descrição: dc.description | Botucatu Sao Paulo State Univ, Med Sch, Obstet Dept, Botucatu, SP, Brazil | - |
Formato: dc.format | 9 | - |
Idioma: dc.language | en | - |
Publicador: dc.publisher | Bmc | - |
Relação: dc.relation | Bmc Pregnancy And Childbirth | - |
???dc.source???: dc.source | Web of Science | - |
Palavras-chave: dc.subject | Pre-eclampsia | - |
Palavras-chave: dc.subject | Preterm birth | - |
Palavras-chave: dc.subject | Prematurity | - |
Palavras-chave: dc.subject | sFlt-1 | - |
Palavras-chave: dc.subject | PlGF | - |
Palavras-chave: dc.subject | fullPIERS | - |
Título: dc.title | PREPARE: protocol for a stepped wedge trial to evaluate whether a risk stratification model can reduce preterm deliveries among women with suspected or confirmed preterm pre-eclampsia | - |
Tipo de arquivo: dc.type | livro digital | - |
Aparece nas coleções: | Repositório Institucional - Unesp |
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