Fetal Electrophysiologic Abnormalities in High-risk Pregnancies Associated With Fetal Demise
Medical College of Wisconsin
Summary
Each year world-wide, 2.5 million fetuses die unexpectedly in the last half of pregnancy, 25,000 in the United States, making fetal demise ten-times more common than Sudden Infant Death Syndrome. This study will apply a novel type of non-invasive monitoring, called fetal magnetocardiography (fMCG) used thus far to successfully evaluate fetal arrhythmias, in order to discover potential hidden electrophysiologic abnormalities that could lead to fetal demise in five high-risk pregnancy conditions associated with fetal demise.
Description
Fetal demise occurs in over 25,000 pregnancies annually in the US and over 2.5 million in pregnancies worldwide. Certain maternal-fetal-placental abnormalities can have a high risk of fetal demise. Despite advances in fetal surveillance with ultrasound and cardiotocography, the reduction in fetal mortality lags behind that of the neonate and has shown little decline in the past decade. This suggests that the type of fetal monitoring used may not be assessing the correct indicators of mortality. In all other age groups, electrocardiographic (ECG) and continuous heart rate (HR) monitoring are us…
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * Current pregnancy complicated by one of the five diagnostic categories * prior unexplained Stillbirth at/after 20 weeks gestation * fetal major congenital heart defect * fetal hydrops * fetal gastroschisis * monochorionic twin pregnancy * Subject must be 18 years of age or older * Subject must be English speaking and must be able to read and sign the consent form in English * Subject must be able to recline comfortably for 1-3 hours * Subject must be willing to complete all three procedures (fMCG, fMCG, nECG) as per protocol, unless medically unable * Subject…
Interventions
- Diagnostic TestFetal Magnetocardiogram and Neonatal Electrocardiogram
Fetal Magnetocardiography (fMCG) is a new non-invasive diagnostic procedure that records tiny fetal cardiac signals similar to an Electrocardiogram or Holter monitor. The magnetometer has FDA clearance, and does not emit magnetic, electric or other energies. This is not an MRI. Examples of fetal MCG's can be found in the Links. The American Heart Association Scientific Statement on Fetal Diagnosis and Treatment (Circulation, 2014) has declared fMCG to be Class IIa for fetal heart rhythm abnormalities, meaning that benefit far exceeds risk. As part of this study, a neonatal electrocardiogram (nECG) will be obtained for comparison after the baby is born.
- GeneticSubstudy only: Maternal/Infant Pharmacogenomic assessment postnatally
See also section 6. Pharmacogenomics measure the way the liver breaks down medications. The systems controlling this are inherited, and mothers or infants can be normal, fast, ultrafast, or poor metabolizers for certain drugs. This study will attempt to improve future safety of cardiac drug treatments for both mother and fetus by evaluating the impact of PG.
Locations (2)
- University of Wisconsin - MadisonMadison, Wisconsin
- Medical College of WisconsinMilwaukee, Wisconsin