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NCT04373902Completed

Physiological-based Cord Clamping in Congenital Diaphragmatic Hernia

Physiological-based Cord Clamping Versus Immediate Cord Clamping for Infants Born With Congenital Diaphragmatic Hernia: a Multicentre, Randomised Controlled Trial

Source: ClinicalTrials.gov · Last updated 25 Sept 2026

Brief summary (registry, in English)

Pulmonary hypertension is a major determinant of postnatal survival in infants with a congenital diaphragmatic hernia (CDH). The current care during the perinatal stabilisation period in infants born with this rare birth defect might contribute to the development of pulmonary hypertension after birth - in particular umbilical cord clamping before lung aeration. An ovine model of diaphragmatic hernia demonstrated that cord clamping after lung aeration, called physiological-based cord clamping (PBCC), avoided the initial high pressures in the lung vasculature while maintaining adequate blood flow, thereby avoiding vascular remodelling and aggravation of pulmonary hypertension. The investigators aim to investigate if the implementation of PBCC in the perinatal stabilisation period of infants born with a CDH could reduce the incidence of pulmonary hypertension in the first 24 hours after birth. The investigators will perform a multicentre, randomised controlled trial in infants with an isolated CDH. Before birth, infants will be randomised to either PBCC or immediate cord clamping, stratified by treatment centre and severity of pulmonary hypoplasia on antenatal ultrasound. For performing PBCC a purpose-designed resuscitation module (the Concord Birth Trolley) will be used.

Status (registry)
Completed
Study type
Interventional
Enrollment
144 (actual)
First submitted
14 Apr 2020
Start date
11 May 2020
Primary completion date
1 Jan 2026
Lead sponsor
Erasmus Medical Center
NCT number
NCT04373902

What you commit to

  • Study type: Interventional
  • Participants enrolled: 144
  • From 11 May 2020 to the primary completion date, 1 Jan 2026
  • 9 sites in 7 countries
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Other illness

  • Cases that have been treated during pregnancy with experimental drug therapy aiming to decrease the occurrence of pulmonary hypertension

Age

  • Gestational age at delivery \<35.0 weeks

Other

  • Right-sided or bilateral CDH
  • Maternal contraindications: anterior placenta praevia, placental abruption
  • High urgency caesarean section, with intended interval to delivery \<15 min
  • Twin pregnancies in which the infant diagnosed with a CDH is born first
  • Multiple birth \>2 (triplets or higher order)

Who the study is looking for

  • Left-sided CDH
  • Isolated CDH: no associated structural or genetic abnormalities that are diagnosed before birth
  • Gestational age at delivery ≥35.0 weeks
  • Parental written informed consent

Age in the registry: 35 weeks to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (9)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Medical University Graz
Coordinator of this site? Confirm its status
GrazAustriaUnknown status
Monash University
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MelbourneAustraliaUnknown status
University Hospitals Leuven
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LeuvenBelgiumUnknown status
Universitätskrankenhaus Bonn
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BonnGermanyUnknown status
Universitätsklinik Mannheim
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MannheimGermanyUnknown status
Ospedale Pediatrico Bambino Gesù
Coordinator of this site? Confirm its status
RomeItalyUnknown status
Radboudumc University Medical Center
Coordinator of this site? Confirm its status
NijmegenNetherlandsUnknown status
Erasmus MC University Medical Center - Sophia Children's Hospital
Coordinator of this site? Confirm its status
RotterdamNetherlandsUnknown status
Karolinska University Hospital
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StockholmSwedenUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.