Could the Cerebral Oximetry be a Good Technology to Measure Placental Oxygenation?
Could the Cerebral Oximetry (NIRS) be a Good Technology to Measure Placental Oxygenation in Pregnant Woman?
研究概览
详细说明
There is general agreement among experts to recommend the use of phenylephrine as first line therapy for the treatment of arterial hypotension induced by spinal anaesthesia during caesarean delivery. In some studies, there are trends toward a lower PaO2 values in the umbilical cord venous blood when the mother receive this vasopressor. These findings may be a result of the vasoconstrictor effect of phenylephrine on utero-placental vessels, and a subsequent increased oxygen extraction by the fetus. The possibility to extract more oxygen would provide a certain "safety margin" in the event of compromised utero-placental blood flow during normal pregnancy. However, this "safety margin" should not be taken for granted in cases where signs of fetal distress are present, and this situation might influence the choice of vasopressors.
It is well establish on a physiological basis that during labour, utero-placental blood flow is lower during the contractions. This lower blood flow could result in a lower saturation value measured by the cerebral oximeter.
Twenty patients in labour will be included in this study. Patients will be recruited in obstetric clinic during pregnancy. Based on the second trimester ultrasound, patients with anterior placenta will be included.
During labour, once a functional epidural is in place, an Invos oximeter will be install. Two sensors will be applied on the abdomen (one above the placenta and the other above the myometrium at a place without placenta). Two sensors will also be applied on the extremities (forearm and leg).Saturation values and timing of the contractions will be recorded for sixty minutes. Half of the recording will be done with an oxygen mask. Vitals signs will also be registered every five minutes.
研究类型
注册 (实际的)
联系人和位置
学习地点
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Quebec
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Montreal、Quebec、加拿大、H1T 2M4
- Maisonneuve Rosemont Hospital
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- healthy pregnant woman (ASA I or II)
- Term gestation ( > 37 weeks)
- Normal pregnancy
- vaginal delivery
- obstetrical epidural in place
- anterior placenta
Exclusion Criteria:
- patient refusal
- Any contraindication to neuraxial anesthesia
- cesarean section
- multiple gestation
- placentation abnormalities
- anormal placental perfusion
- Placental Abruption
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
干预/治疗 |
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anterior placenta
Cerebral oximetry device used to obtain: Saturation value of the placenta probe with no oxygen, saturation value of the placenta probe with oxygen, saturation value of the myometrium probe with no oxygen saturation value of the myometrium probe with oxygen saturation value of the forearm probe with no oxygen, saturation value of the forearm probe with oxygen saturation value of the leg probe with no oxygen saturation value of the leg probe with oxygen Timing between the contractions measure by cardiotocography |
tissue saturation measurement in pregnant women
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Difference between Δp and Δm
大体时间:60 minutes
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Δp = Difference between the mean value area under the curve for the placenta and arm = (Ap- Af) Δm= Difference between the mean value area under the curve for the myometrium and arm = (Am- Af)
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60 minutes
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Difference of the area under the curve of saturation with and without oxygen
大体时间:60 minutes
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Ap with Oxygen - Ap without oxygen; Am with oxygen - Am without oxygen
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60 minutes
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合作者和调查者
调查人员
- 首席研究员:Christian Loubert, MD, FRCPC、Maisonneuve-Rosemont Hospital
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- LoubertHMR2013/04
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cerebral oximetry的临床试验
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Instituto Nacional de Cardiologia de Laranjeiras招聘中