Passive Descent in Obese Nulliparous Gravidae
5. marts 2014 opdateret af: Alisse Hauspurg, Women and Infants Hospital of Rhode Island
Can Passive Descent Increase the Spontaneous Vaginal Delivery Rate in Obese Women?
Obesity rates in reproductive aged women in the United States are rising.
It is now universally accepted that obesity is associated with many adverse pregnancy outcomes and post-operative complications following cesarean section.
Recent studies have also shown an increased rate of cesarean section in obese women, adding to the already elevated rate of complications and adverse outcomes.
Given the increased a priori risk for obese patients, it is vital that the investigators reexamine management practices routinely used for normal weight women in this specific high-risk population.
Passive descent has been shown to increase the spontaneous vaginal delivery rate in non-obese women; however, high quality studies have never been performed in obese women.
the investigators hypothesize that passive descent could improve the spontaneous vaginal delivery rate in nulliparous, obese women with regional anesthesia.
This study will randomize women to passive descent for ninety minutes or active pushing upon entry into the second stage.
Further, given that passive descent is widely accepted in the midwifery literature and clinical practice, the investigators anticipate that a high-quality study in the physician literature could increase the dialogue between practitioners and lead to development of best practices in this high-risk population.
Studieoversigt
Status
Ukendt
Intervention / Behandling
Undersøgelsestype
Interventionel
Tilmelding (Forventet)
540
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
Rhode Island
-
Providence, Rhode Island, Forenede Stater, 02905
- Women and Infants Hospital
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
N/A
Køn, der er berettiget til at studere
Kvinde
Beskrivelse
Inclusion Criteria:
- Obese - body mass index (BMI) calculated as weight (kg)/ [height (m2)] greater than or equal to 30 as determined at the time of admission to labor and delivery
- Regional anesthesia
- Nulliparous (defined as no deliveries after 20 weeks gestation)
- Gestational age of 37 0/7 weeks and greater
- Singleton Pregnancy
Exclusion Criteria:
- Body mass index (BMI) calculated as weight (kg)/ [height (m2)] less than 30 as determined at the time of admission to labor and delivery
- No regional anesthesia
- Multiparous
- Gestational age of less than 37 0/7 weeks
- Multiple gestations
- Maternal fever prior to second stage
- Severe fetal anomalies (incompatible with life)
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Aktiv komparator: Immediate Pushing
Patient's will begin to push when they are determined to be completely dilated.
|
|
|
Eksperimentel: Passive Descent
Patient's will wait 90 minutes prior to begin pushing
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Rate of spontaneous vaginal delivery
Tidsramme: At delivery
|
At delivery
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Rate of infections (defined as fever and / or antibiotic initiation)
Tidsramme: participants will be followed for the duration of hospital stay, an expected average of 3 days
|
participants will be followed for the duration of hospital stay, an expected average of 3 days
|
|
|
Rate of Third and Fourth Degree Lacerations
Tidsramme: At delivery
|
At delivery
|
|
|
Rate of Postpartum Hemorrhage
Tidsramme: At delivery
|
At delivery
|
|
|
Neonatal Outcomes
Tidsramme: At delivery
|
|
At delivery
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Efterforskere
- Ledende efterforsker: Alisse Hauspurg, MD, Women & Infant's Hospital
- Studieleder: Erika Werner, MD, Women & Infant's Hospital
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Primær færdiggørelse (Forventet)
1. juni 2015
Datoer for studieregistrering
Først indsendt
3. marts 2014
Først indsendt, der opfyldte QC-kriterier
5. marts 2014
Først opslået (Skøn)
6. marts 2014
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
6. marts 2014
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
5. marts 2014
Sidst verificeret
1. marts 2014
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- WIHRI-PD
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Pushing
-
Guadarrama HospitalUniversidad Francisco de VitoriaAfsluttet
-
TC Erciyes UniversityAfsluttetForebyggelse | Nyfødt komplikationKalkun