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
Sites (9)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Medical University Graz Coordinator of this site? Confirm its status | Graz | Austria | Unknown status |
| Monash University Coordinator of this site? Confirm its status | Melbourne | Australia | Unknown status |
| University Hospitals Leuven Coordinator of this site? Confirm its status | Leuven | Belgium | Unknown status |
| Universitätskrankenhaus Bonn Coordinator of this site? Confirm its status | Bonn | Germany | Unknown status |
| Universitätsklinik Mannheim Coordinator of this site? Confirm its status | Mannheim | Germany | Unknown status |
| Ospedale Pediatrico Bambino Gesù Coordinator of this site? Confirm its status | Rome | Italy | Unknown status |
| Radboudumc University Medical Center Coordinator of this site? Confirm its status | Nijmegen | Netherlands | Unknown status |
| Erasmus MC University Medical Center - Sophia Children's Hospital Coordinator of this site? Confirm its status | Rotterdam | Netherlands | Unknown status |
| Karolinska University Hospital Coordinator of this site? Confirm its status | Stockholm | Sweden | Unknown status |
This page is information, not medical advice. Discuss any trial with your doctor.