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Trial registered on ANZCTR
Registration number
ACTRN12608000643370
Ethics application status
Approved
Date submitted
5/11/2008
Date registered
17/12/2008
Date last updated
16/11/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Fetal Middle Cerebral Artery (MCA) Doppler to time second and subsequent transfusions for women with red cell alloimmunisation: A randomised trial
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Scientific title
Fetal Middle Cerebral Artery (MCA) Doppler to time second and subsequent transfusions for women with red cell alloimmunisation: A randomised trial
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Secondary ID [1]
290554
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Red cell alloimmunisation in pregnancy
3927
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Condition category
Condition code
Reproductive Health and Childbirth
4123
4123
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Middle Cerebral Artery (MCA) Doppler ultrasound
The Middle Cerebral Artery (MCA) Doppler ultrasound will be used to determine the timing of second and subsequent fetal blood transfusions where one intrauterine fetal transfusion has been performed for anaemia due to red cell alloimmunisation.
This is an ultrasound examination where the speed of blood flow in the fetal brain is assessed, and is performed during pregnancy. It is used to identify if the fetus is at risk of anaemia. The ultrasound examination takes approximately 10 minutes to perform. Because of the nature of red cell alloimmunisation it is often necessary to perform these ultrasound examinations several times over the course of a pregnancy.
Women who participate in the study will be followed to four months after birth.
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Intervention code [1]
3645
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Diagnosis / Prognosis
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Comparator / control treatment
Standard nomogram
The standard nomogram is a chart which takes into account the gestation of the pregnancy, the amount of blood transfused to the fetus, the haemoglobin concentration before and after the transfusion. It then charts the expected fall in haemoglobin and using this information it is possible to time the second transfusion.
Because of the nature of red cell alloimmunisation, several blood transfusions for the fetus are often required during the course of the pregnancy.
At present the standard nomogram is used each time a woman undergoes an intra-uterine fetal blood sample. The precise number of transfusions varies for each pregnancy.
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Control group
Active
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Outcomes
Primary outcome [1]
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Cord blood haemoglobin.
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Assessment method [1]
5013
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Timepoint [1]
5013
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Measured in cord blood taken at time of birth.
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Secondary outcome [1]
8460
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Procedure related complications necessitating emergency delivery.
These complications are documented in the woman's case notes and will be obtained from review of the case notes.
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Assessment method [1]
8460
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Timepoint [1]
8460
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Pregnancy.
Information about these complications will be collected from the case notes at the end of pregnancy.
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Secondary outcome [2]
8461
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Other adverse infant outcomes related to alloimmunisation.
These complications are documented in the woman's case notes and will be obtained from review of the case notes.
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Assessment method [2]
8461
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Timepoint [2]
8461
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Birth
Information about these complications will be collected from the case notes at the end of pregnancy and after the woman and infant have been discharged.
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Secondary outcome [3]
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Adverse outcomes for the woman.
Information about these complications will be collected from the case notes at the end of pregnancy.
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Assessment method [3]
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Timepoint [3]
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Pregnancy and birth
Information about these complications will be collected from the case notes at the end of pregnancy and after the woman and infant have been discarged.
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Secondary outcome [4]
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Adverse outcomes for the infant related to alloimmunisation. This includes the presence of anaemia (both at the time of transfusion and at the time of the baby's birth) as measured on cord blood from the baby. This information is collected routinely from babies who require in-utero blood transfusion and will be extracted from information contained in the woman and infant's case notes.
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Assessment method [4]
329399
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Timepoint [4]
329399
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Birth - anaemia will be determined by cord blood taken at the time of birth.
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Eligibility
Key inclusion criteria
Pregnant women whose fetus has anaemia secondary to red cell alloimmunisation (due to any red cell antibody alone or in combination) as indicated by the need to have performed a single intra-uterine fetal blood transfusion
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Minimum age
18
Years
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Maximum age
48
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Women whose fetus has anaemia secondary to any other cause; known fetal chromosomal anomalies
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central telephone randomisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated randomisation sequence
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
1/01/2009
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Actual
19/10/2009
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Date of last participant enrolment
Anticipated
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Actual
1/10/2013
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Date of last data collection
Anticipated
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Actual
30/07/2016
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Sample size
Target
564
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Accrual to date
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Final
75
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Recruitment in Australia
Recruitment state(s)
QLD,SA,WA
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Recruitment outside Australia
Country [1]
1350
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Canada
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State/province [1]
1350
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Ontario; Quebec, British Columbia
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Country [2]
8393
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United Kingdom
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State/province [2]
8393
0
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Country [3]
8394
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Ireland
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State/province [3]
8394
0
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Country [4]
8395
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Argentina
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State/province [4]
8395
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Country [5]
8396
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New Zealand
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State/province [5]
8396
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Funding & Sponsors
Funding source category [1]
4109
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University
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Name [1]
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The University of Adelaide
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Address [1]
4109
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Discipline of Obstetrics & Gynaecology
72 King William Road
North Adelaide 5006
South Australia
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Country [1]
4109
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Australia
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Funding source category [2]
294990
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Government body
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Name [2]
294990
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NHMRC
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Address [2]
294990
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [2]
294990
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Australia
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Primary sponsor type
University
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Name
The University of Adelaide
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Address
Discipline of Obstetrics and Gynaecology
72 King William Road
North Adelaide 5006
South Australia
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Country
Australia
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Secondary sponsor category [1]
3757
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None
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Name [1]
3757
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Address [1]
3757
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Country [1]
3757
0
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Secondary sponsor category [2]
3877
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None
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Name [2]
3877
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Address [2]
3877
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Country [2]
3877
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Other collaborator category [1]
463
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Individual
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Name [1]
463
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Professor Greg Ryan
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Address [1]
463
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Mt Sinai Hospital
700 University Avenue
Toronto Ontario M5G 2X4
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Country [1]
463
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Canada
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
6183
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Mt Sinai Hospital
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Ethics committee address [1]
6183
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700 University Avenue Toronto Ontario M5G 2X4
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Ethics committee country [1]
6183
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Canada
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Date submitted for ethics approval [1]
6183
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Approval date [1]
6183
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31/08/2009
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Ethics approval number [1]
6183
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Ethics committee name [2]
296343
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Women's and Children's Health Network HREC
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Ethics committee address [2]
296343
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72 King William St, North Adelaide 5006 South Australia
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Ethics committee country [2]
296343
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Australia
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Date submitted for ethics approval [2]
296343
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15/12/2008
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Approval date [2]
296343
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27/07/2009
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Ethics approval number [2]
296343
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REC 2148/2/12
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Summary
Brief summary
The aim of this study is to assess in the fetus where one intrauterine fetal transfusion has been performed for anaemia due to red cell alloimmunisation, whether fetal middle cerebral artery (MCA) Doppler can be safely used to determine the timing of second and subsequent fetal blood transfusions, without increasing the risk of adverse fetal and neonatal health outcomes. Red cell alloimmunisation is estimated to affect 0.1 to 0.6% of all live births. Treatment of the resultant fetal anaemia with intrauterine fetal blood transfusion has been associated with survival rates in excess of 90%. However, intrauterine fetal blood sampling and transfusion is an invasive procedure, with recognised complications, which may result in the need for early birth, and rarely mortality. More recently, reports have emerged utilising Doppler ultrasound to measure the fetal middle cerebral artery (MCA) peak systolic velocity (PSV) to determine the presence of fetal anaemia.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
29096
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Prof Jodie Dodd
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Address
29096
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The University of Adelaide
72 King William St,
North Adelaide 5006 South Australia
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Country
29096
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Australia
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Phone
29096
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+61881617619
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Fax
29096
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Email
29096
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[email protected]
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Contact person for public queries
Name
12253
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Jodie Dodd
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Address
12253
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72 King William Road
North Adelaide 5006
South Australia
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Country
12253
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Australia
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Phone
12253
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+61 8 8161 7619
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Fax
12253
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+61 8 8161 7652
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Email
12253
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[email protected]
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Contact person for scientific queries
Name
3181
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Jodie Dodd
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Address
3181
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72 King William Road
North Adelaide 5006
South Australia
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Country
3181
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Australia
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Phone
3181
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+61 8 8161 7619
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Fax
3181
0
+61 8 8161 7652
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Email
3181
0
[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
89: Exploring the diagnostic and prognostic potential of amniotic fluid exosomes in twin-twin transfusion syndrome (TTTS)
2017
https://doi.org/10.1016/j.ajog.2016.11.977
N.B. These documents automatically identified may not have been verified by the study sponsor.
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