NCT05742971

Brief Summary

SUMMARY Rationale: The use of an external cephalic version (ECV) to rotate the fetus from a non-cephalic to cephalic presentation reduces the rate of caesarean section by approximately two-thirds in term pregnancies with breech presentation. Reducing pain during external cephalic version can contribute to an increase in success rate and consequently reduce the number of cesarean sections. Literature about the effectivity of virtual reality (VR) on acute pain reduction seems promising. Objective: The primary objective of this study is to explore the effect of VR on pain during ECV. Secondary objectives are the rate of successful ECV procedures and to explore tolerability, feasibility and patient satisfaction of VR use. Study design: The study concerns a non-blinded, single centre, randomised controlled trial. Study population: Eligible women who fulfill the inclusion criteria and are scheduled for an external cephalic version in the Zuyderland Medical Centre location Heerlen. Intervention: The study population will be randomly divided into the intervention group (VR-group) or the standard care group. The intervention group can choose for an immersive guided relaxation VR experience or an interactive VR experience during the external version additional to the usual standard care. The participants randomised to the standard care group receive the usual standard care given during external version. Main study parameters/endpoints: The primary outcome is pain measured on a numeric rating scale (NRS). A total of 42 patients have to be included in each group. This means that a total of 84 women will have to be included in the study. Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Each participating woman is asked to complete a questionnaire after using VR and the degree of pain perception is questioned on the basis of a 0-10 score (NRS). The study population experiences a very small medical risk when participating to this study. They can experience side-effects of VR for example dizziness or nausea and in rare cases epileptic insults.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
85

participants targeted

Target at P50-P75 for not_applicable pain

Timeline
Completed

Started Nov 2020

Longer than P75 for not_applicable pain

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 19, 2020

Completed
2.2 years until next milestone

First Submitted

Initial submission to the registry

February 9, 2023

Completed
15 days until next milestone

First Posted

Study publicly available on registry

February 24, 2023

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2023

Completed
Last Updated

August 20, 2024

Status Verified

February 1, 2023

Enrollment Period

3.1 years

First QC Date

February 9, 2023

Last Update Submit

August 19, 2024

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change of pain during ECV when using VR (VAS, visual analogue scale)

    pain score by VAS visual analogue scale minimum 0-maximum 10 (higher score is a worse outcome).

    15 minutes

Secondary Outcomes (2)

  • Rate of successful ECV procedures

    15 minutes

  • Patient tolerability, feasibility and satisfaction of VR use (questionnaire)

    15 minutes

Study Arms (2)

VR group

EXPERIMENTAL

The intervention group can choose for an immersive guided relaxation VR experience or an interactive VR experience during the external version Immediately after the external version, a pain measurement is taken with regard to the pain during the ECV by means of the NRS score. After the ECV procedure, participants of the VR-group receive a structured questionnaire in which tolerability, feasibility and satisfaction of VR use is evaluated.

Device: Virtual reality intervention performed through the Oculuc Go VR glasses

Standard care group

NO INTERVENTION

The participants randomised to the standard care group receive the usual standard care given during external version.Immediately after the external version, a pain measurement is taken with regard to the pain during the ECV by means of the NRS score.

Interventions

The participants randomised into this group are offered a VR intervention during the external version for 5-10 minutes in addition to the standard care of an ECV. The VR is performed through the Oculus Go VR glasses. These women can choose for an immersive guided relaxation VR experience or an interactive VR experience (see descriptions below). The ECV expert executing the ECV will register immediately after the ECV which option the patients has chosen. Immediately after the external version, a pain measurement is taken with regard to the pain during the ECV by means of the NRS score. After the ECV procedure, participants of the VR-group receive a structured questionnaire in which tolerability, feasibility and satisfaction of VR use is evaluated.

VR group

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Written and orally given informed consent
  • years and older
  • Native Dutch speaker
  • Singleton pregnancy in breech position
  • Scheduled ECV

You may not qualify if:

  • Contraindication for ECV
  • Chronic pain patients defined as 'persistent or recurrent pain lasting longer than 3 months' \[16\]. The pain is not due to an obstetrical problem.
  • Chronic use of pain medication (opioids)
  • Alcohol or drug abuse
  • Known car sickness
  • Epileptic insults in previous history
  • Psychotically seizures in previous history
  • Claustrophobic
  • Blindness
  • History of mental illness
  • Patients in strict isolation (MRSA)
  • Age \<18 years
  • Twin pregnancy
  • No native Dutch speaker

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Zuyderaland MC

Heerlen, 6419 PC, Netherlands

Location

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

Neurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • M Wassen, Dr

    Zuyderland MC

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
INVESTIGATOR
Masking Details
The study population will be randomly divided into the intervention group (VR-group) or the standard care group.
Purpose
OTHER
Intervention Model
PARALLEL
Model Details: The study population will be randomly divided into the intervention group (VR-group) or the standard care group. The intervention group can choose for an immersive guided relaxation VR experience or an interactive VR experience during the external version additional to the usual standard care. The participants randomised to the standard care group receive the usual standard care given during external version.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 9, 2023

First Posted

February 24, 2023

Study Start

November 19, 2020

Primary Completion

December 31, 2023

Study Completion

December 31, 2023

Last Updated

August 20, 2024

Record last verified: 2023-02

Locations