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CTRI Number  CTRI/2024/08/072780 [Registered on: 20/08/2024] Trial Registered Prospectively
Last Modified On: 06/04/2026
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group, Placebo Controlled Trial 
Public Title of Study   Improving maternal and foetal outcomes among pregnant women suffering from sickle cell disease in Gujarat, India 
Scientific Title of Study   Effectiveness of Hydroxyurea along with standard of care compared to only standard of care on adverse maternal and foetal outcomes: A randomised controlled trial among pregnant women suffering from sickle cell disease in Gujarat, India 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Gayatri Desai 
Designation  Gynecologist 
Affiliation  SEWA Rural 
Address  SEWA Rural Department of Community Health and Research, Tower road, Jhagadia, Bharuch GUJARAT 393110 India
SEWA Rural Department of Community Health and Research, Tower road, Jhagadia, Bharuch GUJARAT 393110 India
Bharuch
GUJARAT
393110
India 
Phone    
Fax    
Email  gayatri.desai@sevarural.org  
 
Details of Contact Person
Scientific Query
 
Name  Shrey Desai 
Designation  Research Director 
Affiliation  SEWA Rural 
Address  SEWA Rural Department of Community Health and Research, Tower road, Jhagadia, Bharuch GUJARAT 393110 India
SEWA Rural Department of Community Health and Research, Tower road, Jhagadia, Bharuch GUJARAT 393110 India
Bharuch
GUJARAT
393110
India 
Phone  9429109050  
Fax    
Email  shrey.desai@sevarural.org  
 
Details of Contact Person
Public Query
 
Name  Shrey Desai 
Designation  Research Director 
Affiliation  SEWA Rural 
Address  SEWA Rural Department of Community Health and Research, Tower road, Jhagadia, Bharuch GUJARAT 393110 India
SEWA Rural Department of Community Health and Research, Tower road, Jhagadia, Bharuch GUJARAT 393110 India

GUJARAT
393110
India 
Phone  9429109050  
Fax    
Email  shrey.desai@sevarural.org  
 
Source of Monetary or Material Support  
Kasturba Maternity Hospital, SEWA Rural, Tower road, Jhagadia, District: Bharuch, Gujarat PIN 393110  
 
Primary Sponsor  
Name  SEWA Rural 
Address  Kasturba Maternity Hospital, SEWA Rural, Tower road, Jhagadia, District: Bharuch, Gujarat PIN 393110 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Shrey Desai  Kasturba Hospital  Kasturba Maternity Hospital, SEWA Rural, Tower road, Jhagadia, District: Bharuch, Gujarat PIN 393110
Bharuch
GUJARAT 
9429109050

shrey.desai@sevarural.org 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
SEWA Rural IEC  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: D759||Disease of blood and blood-formingorgans, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Hydroxyurea medicine and standard treatment  The intervention group will receive the current standard treatment and hydroxyurea medicine. Hydroxyurea will be started as per the national guidelines at 10-15 mg/kg/day orally. Hydroxyurea will be started as early as possible during the second trimester. Hydroxyurea will be continued up to delivery unless the patient experiences its side effects. The standard antenatal care will be provided as per the clinical protocol of the hospital. This will include administration of the aspirin (150 mg daily), folic acid supplementation, iron supplementation, vitamin-D supplementation, calcium supplementation, regular sonographies, education of the patient and family members, and care in case of complications during the antenatal period. Top-up blood transfusion will be given for acute anaemia or sudden large reduction in hemoglobin level. Women will undergo induction of labour at 37 weeks of gestation in most cases, and will be closely monitored, especially during the first 12 hours postpartum. Standard inpatient care will be provided as per the clinical protocol of the hospital in case a patient is admitted for any obstetric, medical or sickle cell related complications with emphasis on volume management and prophylaxis for venous thromboembolic events.  
Comparator Agent  standard treatment  The standard antenatal care will be provided as per the clinical protocol of the hospital. This will include administration of the aspirin (150 mg daily), folic acid supplementation, iron supplementation, vitamin-D supplementation, calcium supplementation, regular sonographies, education of the patient and family members, and care in case of complications during the antenatal period. Top-up blood transfusion will be given for acute anaemia or sudden large reduction in hemoglobin level. Women will undergo induction of labour at 37 weeks of gestation in most cases, and will be closely monitored, especially during the first 12 hours postpartum. Standard inpatient care will be provided as per the clinical protocol of the hospital in case a patient is admitted for any obstetric, medical or sickle cell related complications with emphasis on volume management and prophylaxis for venous thromboembolic events.  
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  45.00 Year(s)
Gender  Female 
Details  All consenting pregnant women with sickle cell disease seeking outpatient or inpatient care at Kasturba Maternity Hospital or its satellite center during the second trimester of pregnancy will be eligible for enrolment. Sickle cell disease status will be confirmed by a gold standard laboratory test- HPLC.  
 
ExclusionCriteria 
Details  Dont, provide consent, out of study area, already on hydroxyurea treatment, not intended to get services at SEWA Rural, and those who have already the presence of contra indication to hydroxyurea medicine at baseline which includes neutropenia, thrombocytopenia, abnormal increase in serum creatinine, or hepatitis. 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   On-site computer system 
Blinding/Masking   Double Blind Double Dummy 
Primary Outcome  
Outcome  TimePoints 
1. Adverse maternal outcome event score per person month will be primary outcome.

2. Time to first time occurrence of severe maternal adverse event since last menstruation period.  
The outcome will be assessed at interim midline (at one year) and endline (at two years).  
 
Secondary Outcome  
Outcome  TimePoints 
Secondary outcomes will be event rates per 100 person months for each of adverse maternal outcomes & foetal outcomes.   The outcome will be assessed at interim midline (at one year) & at endline (at two years).  
 
Target Sample Size   Total Sample Size="98"
Sample Size from India="98" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 2 
Date of First Enrollment (India)   02/09/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="6"
Days="30" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Yet Recruiting 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form

  3. Who will be able to view these files?
    Response - Anyone

  4. For what types of analyses will this data be available?
    Response - Any purpose.

  5. By what mechanism will data be made available?
    Response - To gain access, data requestors will need to sign a data access agreement. Data are available for 5 years at a third party website (Database not finalised now, will update later).

  6. For how long will this data be available start date provided 01-09-2024 and end date provided 31-08-2029?
    Response - Beginning 9 months and ending 36 months following article publication.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  

Sickle cell disease is an inherited blood disorder characterized by the tendency of red blood cells to become sickle-shaped and block capillaries, leading to vaso-occlusion and anaemia. Pregnant women who have Sickle cell disease (SCD) have an increased risk for adverse maternal, fetal and neonatal outcomes. Despite providing the standard of care, maternal and fetal outcomes have been unfavourable in a variety of clinical settings, even in high-income countries. We propose doing a randomized control academic trial with consenting patients in one arm to receive Hydroxyurea medicine after the first trimester of pregnancy along with standard care and the control arm to receive standard care only. This study will be conducted at Kasturba Maternity Hospital managed by a voluntary organization SEWA-Rural situated in the Jhagadia block of the Bharuch district in Gujarat, India. Jhagadia block has a population of 155,000. Almost 70% of the population is tribal/indigenous. This will be a parallel-group design, double-blind, stratified, randomized controlled trial. The Hydroxyurea medicine will be started as early as possible during the second trimester, and it will be continued up to delivery unless the patient experiences its side effects. The standard antenatal care will be provided as per the clinical protocol of the hospital. Hydroxyurea will be started as per the national guidelines at 10-15 mg/kg/day orally. The primary outcome of interest is 1. Adverse maternal outcome event score per person per month in the intervention group in compared to the control group. 2.   Time to first-time occurrence of severe maternal adverse event. The required sample size based on sample size calculations as per primary outcomes was 39. After calculating loss to follow-up (15%) and MTP/abortion 10% we will need a total of 49 women in a group. We will do a mixed effect regression model and survival analysis to find differences between the groups for primary outcome indicators respectively. 

 
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