Time-to-Transition

• Research type

  Research Study

• Full title

  Time-to-Transition: A study investigating the feasibility of a ‘Time to Transition Caesarean Section’

• IRAS ID

  325202

• Contact name

  Joanna Crofts

• Contact email

  joanna.crofts@nbt.nhs.uk

• Sponsor organisation

  North Bristol NHS Trust

• Duration of Study in the UK

  0 years, 3 months, 0 days

• Research summary

  Aim:
  Is it feasible to conduct a study to determine if a “Time-to-Transition caesarean birth” improves the health of newborn babies?

  Background:
  In the womb, a baby’s lungs are filled with fluid, which helps them develop. During labour and birth, most of this fluid goes away, and the baby adapts to breathing air.
  When babies are born quickly by caesarean, they may not have enough time to clear the fluid, so the lungs remain “wet”, making it harder to breathe. They breathe faster and shallower, a condition called Transient Tachypnea of the Newborn (TTN), and often need antibiotics, breathing support, and a stay in a Neonatal Intensive Care Unit.
  Reducing TTN could reduce the need for this extra care.

  This study will assess a new ‘Time-to-Transition Caesarean Birth’.
  Rather than being born rapidly after opening the womb, the doctor will deliver the baby’s head, keeping the body inside the womb until the baby starts to cry (for a maximum of 2 minutes). This extra time may help the baby transition to breathing air and reduce the risk of TTN.
  As with any caesarean, the mother and baby will be closely monitored. If there are any concerns the baby will be immediately delivered. Everything else about the birth and recovery remain unchanged.

  Methods:
  We will recruit 34 women to have a “Time-to-Transition Caesarean Birth”.
  Women can take part if they are:
  • pregnant with one baby
  • planning a Caesarean birth
  • and if baby’s position is “head-down”
  We will:
  • video the births, to learn from them.
  • collect information about mother and baby from their medical records
  • ask the views of mothers, birth partners, and clinicians

  Future direction:
  If this study demonstrates that it’s feasible and is acceptable, we will undertake a large-scale study comparing newborn outcomes after “Time-to-Transition” and “standard” caesarean births.

• REC name

  South Central - Berkshire B Research Ethics Committee

• REC reference

  23/SC/0228

• Date of REC Opinion

  17 Jul 2023

• REC opinion

  Favourable Opinion