An observational study in Stillbirth, Fetal Death and Fetal Growth Retardation, sponsored by Oxford University Hospitals NHS Trust. Recruiting at 1 site in United Kingdom. Open to female participants aged 16 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-01-29.
Sponsored by Oxford University Hospitals NHS Trust · Observational
Fetal growth restriction during pregnancy represents one of the biggest risk factors for stillbirth (Gardosi et al, 2013), with 'about one in three term, normally formed antepartum stillbirths are related to abnormalities of fetal growth' (MBRRACE, 2015).
Therefore, antenatal detection of growth restricted babies is vital in order to be able to monitor and decide the appropriate delivery timing.
However, antenatal detection of SGA babies has been poor, varying greatly across trusts in England in those that calculate their rates (NHS England, 2016). Most trusts do not calculate their detection rates and rates are therefore unknown. It is estimated that routine NHS care detects only 1 in 4 growth restricted babies (Smith, 2015).
Oxford University Hospitals NHS Foundation Trust, in partnership with the Oxford Academic Health Science Network (AHSN) has introduced a clinical care pathway (the Oxford Growth Restriction Pathway (OxGRIP)) designed to increase the rates of detection of these at risk babies. The pathway is intended to increase the identification of babies who are at risk of stillbirth, in order to try to prevent this outcome, whilst making best usage of resources, and restricting inequitable practice and unnecessary obstetric intervention.
It has been developed with reference to a body of research, however, the individual parts of care provided have not been put together in a pathway in this manner before. Therefore it is important to examine whether the pathway meets its goals of improving outcomes for babies in a 'real world' setting.
The principles of the pathway are
The clinical data routinely collected as a result of the introduction of the pathway offers a valuable and unique resource in identifying and analysing in the effects of the pathway on its intended outcomes and also in investigating and analysing other maternal, fetal and neonatal complications and outcomes, establishing normal / reference ranges for ultrasound values.
There is no requirement for patient participation in this study. All data collected and analysed is routinely collected clinical data.
121 studies on the registry are indexed under Stillbirth; 34 are open to participants now.
This study's planned enrollment of 56,000 is above the median of 480 across 55 observational studies indexed under Stillbirth.
Browse Stillbirth studies →Oxford University Hospitals NHS Trust is the lead sponsor of 94 studies on the registry; 7 are open to participants now.
Counted across the registry records on this site, refreshed daily.
All pregnant women receiving antenatal care at the Oxford University Hospitals NHS Foundation Trust (OUHFT) from January 2013 to 31st December 2019
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Impact of OxGRIP on Perinatal mortality according to gestation
Mortality (stillbirth and neonatal death per 1000 pregnancies) in the period after birth) assessed in 2 years before the programme and compared with the 2 years after the programme started. Assessed for all pregnancies and for those reaching 35 weeks' gestation
Time frame: 4 yrs
Impact of the OxGRIP Pathway on service: number of scans
Number of Ultrasound Scans (\>24 weeks gestation) performed per pregnancy
Time frame: 6 yrs
Impact of the OxGRIP Pathway on service - Consultant time
Number of Consultant appointments
Time frame: 6 yrs
Impact of the OxGRIP Pathway on service - intrapartum interventions
Proportion of all birth delivered as emergency and elective cesarean sections and instrumental deliveries
Time frame: 6 yrs
Risk Factors for adverse outcomes - ultrasound head circumference
Routinely collected ultrasound fetal measurements - Head Circumference. Physiological parameter
Time frame: 4 yrs
Risk Factors for adverse outcomes - ultrasound abdomen circumference
Routinely collected ultrasound fetal measurements - Abdominal Circumference.Physiological parameter
Time frame: 4 yrs
Risk Factors for adverse outcomes - ultrasound femur length
Routinely collected ultrasound fetal measurements - Femur Length. Physiological parameter
Time frame: 4 yrs
Risk Factors for adverse outcomes - ultrasound presentation
Fetal presentation at last scan before birth. Physiological parameter
Time frame: 4 yrs
Risk Factors for adverse outcomes - Doppler ultrasound
Uterine/umbilical artery/ middle cerebral artery Doppler values. Physiological parameter
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: hypertension
Diagnosis of pre eclampsia and related complications. Physiological parameter
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: diabetes
Diagnosis of Gestational Diabetes. Physiological parameter
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: mode of birth
Mode of Delivery
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: preterm birth
Number of preterm births by gestation per 1000 pregnancies
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: stillbirth
Antenatal fetal loss rate per 1000 pregnancies
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: intrapartum stillbirth
Intrapartum fetal loss rate per 1000 pregnancies
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: neonatal death
Neonatal death \<30 days of age: rate per 1000 livebirths
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: infant
Neonatal/infant death \>30 days of age \<1year of age: per 1000 live births
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: neonatal admission
Adverse neonatal outcome - planned/unplanned admission to NICU: rate per 1000 pregnancies
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: HIE
Adverse neonatal outcome - diagnosis of HIE rate per 1000 pregnancies
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: cord gas
Cord Blood Gases outside normal range (umbilical cord arterial pH at birth \<7.00 and \<7.05)
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: Apgar
Apgar score at birth (continuous variable and rate of \<7 at 5 mins)
Time frame: 4 yrs
Clinical outcomes during pregnancy and postnatal/neonatal period: size
Small for Gestational Age birthweight - by Hadlock and Intergrowth centiles. Physiological parameter
Time frame: 4 yrs
Normal ranges of antenatal ultrasound markers.
Development of normal range of routinely collected ultrasound measurements. Physiological parameter
Time frame: 4 yrs
Normal ranges of intrapartum markers.
Cardiotocograph results ( Dawes Redman Criteria). Physiological parameter
Time frame: 4 yrs
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Oxford University Hospitals NHS Trust