- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04934995
Arm and Ankle Blood Pressure Cuffs During C-Section
Comparison of Arm and Ankle Blood Pressure During Cesarean Delivery: A Blood Pressure Cuffs Pilot Study
Study Overview
Status
Intervention / Treatment
Detailed Description
In the last three decades, numerous interventions have been studied and implemented into our daily practice, such as pre-loading versus co-loading, phenylephrine versus ephedrine, and phenylephrine infusion versus intermittent boluses. In addition, the effectiveness of left uterine displacement (LUD) to improve blood flow and pressure remains unclear. Also, there are issues to be addressed on this regard, including:
- Poor placental perfusion from inadequate LUD due to the potential impact of supine hypotensive syndrome (SHS) secondary to aortocaval compression especially after SAB;
- Shivering during cesarean delivery (CD) resulting in inaccurate BP measurements, the incidence of shivering during CD is reported to be 21.9%. It is unclear the impact of shivering during CD on blood pressure (BP) measurements;
- Patient discomfort during BP measurements, calf > arm > ankle
The Investigators are conducting a single center prospective self-control study aiming to validate the effectiveness of LUD after SAB with simultaneous measurements of BP on the arm and left ankle during surgery in patients undergoing cesarean delivery (CD). In addition, the Investigators will determine whether ankle BP correlates more accurately than arm SBP with the incidence of nausea/vomiting and category II or III fetal heart tracing and bradycardia after SAB and LUD under no shivering conditions and the impact of body mass index and antepartum estimation of newborn weight on SHS after the SAB.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Ling-Qun Hu, MD
- Phone Number: 614-293-6302
- Email: LingQun.Hu@osumc.edu
Study Contact Backup
- Name: Alberto Uribe, MD
- Phone Number: 614-293-3559
- Email: alberto.uribe@osumc.edu
Study Locations
-
-
Ohio
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Columbus, Ohio, United States, 43210
- Recruiting
- The Ohio State University
-
Contact:
- Ling-Qun Hu, MD
- Phone Number: 614-293-6302
- Email: LingQun.Hu@osumc.edu
-
Contact:
- Alberto Uribe, MD
- Phone Number: 614-293-3559
- Email: alberto.uribe@osumc.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age ≥ 18 years old
- Women undergoing cesarean delivery at The Ohio State University Wexner Medical Center under spinal anesthesia
- American Society of Anesthesiologists Physical Status I-III
- Body mass index during pregnancy ≥ 35 kg/m2
- Able to consent in English language
- Singleton pregnancy
Exclusion Criteria:
- Women undergoing elective cesarean delivery at The Ohio State University Wexner Medical Center under anesthesia other than spinal anesthesia (i.e. general and/or epidural anesthesia)
- Prisoners
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Study Population
Adult women undergoing cesarean delivery at The Ohio State University Wexner Medical Center under spinal anesthesia, ASA physical status I-III with a BMI during pregnancy ≥ 35 kg/m2 and singleton pregnancy.
|
After obtaining consent and confirming eligibility, Blood Pressure cuffs will be used as specified below: Cuff size: large BP cuffs will be the default size for both arm and ankle measurements, but can be changed as clinically indicated based on circumferences of limbs Cuff location: BP cuffs will be placed on the contralateral arm to the main peripheral IV following standard procedures. Left ankle cuff will be placed underneath intermittent pneumatic compression cuffs Ankle blood pressure monitor screen will be covered. Thus, anesthesia providers will not be able to make any clinical decisions based on ankle blood pressures but arm blood pressure (standard) instead. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference of SBP measured between arm and ankle during elective CD before SAB
Time Frame: Immediately before subarachnoid anesthesia block (after standard of care left uterine displacement maneuver is performed).
|
Arm Systolic Blood Pressure values will be compared with the ankle SBP values before subarachnoid anesthesia.
Baseline SBP will be measured pre-spinal anesthesia in supine position (after standard of care left uterine displacement maneuver is performed).
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Immediately before subarachnoid anesthesia block (after standard of care left uterine displacement maneuver is performed).
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Difference of SBP measured between arm and ankle during elective CD after SAB (before incision)
Time Frame: Immediately after subarachnoid anesthesia block is completed
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Arm Systolic Blood Pressure values will be compared with the ankle SBP values after subarachnoid anesthesia.
Postspinal SBP will be measured in supine position, after LUD is performed
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Immediately after subarachnoid anesthesia block is completed
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of intraoperative nausea in our patient population
Time Frame: Up to 3 hours from OR admission. Immediately before anesthesia (subarachnoid block) and until operating room discharge
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the incidence of intraoperative nausea will be assessed during anesthesia and surgery
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Up to 3 hours from OR admission. Immediately before anesthesia (subarachnoid block) and until operating room discharge
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Incidence of intraoperative vomiting in our patient population
Time Frame: Up to 3 hours from OR admission. Immediately before anesthesia (subarachnoid block) and until operating room discharge
|
the incidence of intraoperative vomiting will be assessed during anesthesia and surgery
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Up to 3 hours from OR admission. Immediately before anesthesia (subarachnoid block) and until operating room discharge
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Ling-Qun Hu, MD, Ohio State University
Publications and helpful links
General Publications
- Klohr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturients. Acta Anaesthesiol Scand. 2010 Sep;54(8):909-21. doi: 10.1111/j.1399-6576.2010.02239.x. Epub 2010 Apr 23.
- Bijker JB, van Klei WA, Kappen TH, van Wolfswinkel L, Moons KG, Kalkman CJ. Incidence of intraoperative hypotension as a function of the chosen definition: literature definitions applied to a retrospective cohort using automated data collection. Anesthesiology. 2007 Aug;107(2):213-20. doi: 10.1097/01.anes.0000270724.40897.8e.
- Hartmann B, Junger A, Klasen J, Benson M, Jost A, Banzhaf A, Hempelmann G. The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection. Anesth Analg. 2002 Jun;94(6):1521-9, table of contents. doi: 10.1097/00000539-200206000-00027.
- Chungsamarnyart Y, Wacharasint P, Carvalho B. Hemodynamic profiles with and without left uterine displacement: A randomized study in term pregnancies receiving subarachnoid blockade for cesarean delivery. J Clin Anesth. 2020 Apr 16;64:109796. doi: 10.1016/j.jclinane.2020.109796. Online ahead of print.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 2020H0502
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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