NCT03252496

Brief Summary

This study will compare between combination of colloids/crystalloids and crystalloids in women with preeclampsia undergoing elective cesarean delivery under spinal anesthesia

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
140

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Aug 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 14, 2017

Completed
3 days until next milestone

First Posted

Study publicly available on registry

August 17, 2017

Completed
2 days until next milestone

Study Start

First participant enrolled

August 19, 2017

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 15, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 15, 2021

Completed
Last Updated

September 5, 2021

Status Verified

September 1, 2021

Enrollment Period

3.9 years

First QC Date

August 14, 2017

Last Update Submit

September 3, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Total urine output at 2 hours post-spinal

    2 hours after intrathecal injection

Secondary Outcomes (11)

  • Urine output at 1 hour post-spinal

    1 hour after intrathecal injection

  • Incidence of oliguria

    2 hours after intrathecal injection

  • Total ephedrine dose

    Intraoperative

  • Pre-delivery ephedrine dose

    From intrathecal injection until delivery

  • Number of patients requiring ephedrine

    Intraoperative

  • +6 more secondary outcomes

Study Arms (2)

Combination

EXPERIMENTAL

250 mL colloid over 5 minutes followed by 500 mL crystalloid over 55 minutes then 250 mL colloid over 60 minutes. Cesarean delivery performed under spinal anesthesia (intrathecal bupivacaine 12.5 mg and intrathecal fentanyl 15 μg). Ultrasound assessment of the Inferior vena cava diameter. Intravenous ephedrine and intravenous syntocinon will be administered.

Procedure: Spinal AnesthesiaDrug: Intrathecal BupivacaineDrug: Intrathecal FentanylProcedure: Cesarean DeliveryRadiation: Ultrasound Assessment of the Inferior Vena CavaDrug: 250 mL Colloid over 5 minutesDrug: 500 mL Crystalloid over 55 minutesDrug: 250 mL Colloid over 60 minutesDrug: Intravenous EphedrineDrug: Intravenous Syntocinon

Crystalloid

ACTIVE COMPARATOR

250 mL crystalloid over 5 minutes followed by 500 mL crystalloid over 55 minutes then 250 mL crystalloid over 60 minutes. Cesarean delivery performed under spinal anesthesia (intrathecal bupivacaine 12.5 mg and intrathecal fentanyl 15 μg). Ultrasound assessment of the Inferior vena cava diameter. Intravenous ephedrine and intravenous syntocinon will be administered.

Procedure: Spinal AnesthesiaDrug: Intrathecal BupivacaineDrug: Intrathecal FentanylProcedure: Cesarean DeliveryRadiation: Ultrasound Assessment of the Inferior Vena CavaDrug: 250 mL Crystalloid over 5 minutesDrug: 500 mL Crystalloid over 55 minutesDrug: 250 mL Crystalloid over 60 minutesDrug: Intravenous EphedrineDrug: Intravenous Syntocinon

Interventions

Performed at the L3-L4 or L4-L5 interspace using 27- or 25-gauge spinal needle

CombinationCrystalloid

Bupivacaine 12.5 mg (2.5 mL 0.5%) will be administered in the subarachnoid space

CombinationCrystalloid

Fentanyl 15 μg will be administered in the subarachnoid space

CombinationCrystalloid

Lower segment cesarean section using the Pfannenstiel incision

CombinationCrystalloid

The inferior vena cava largest and smallest diameters will be measured proximal to the opening of the hepatic veins in the longitudinal axis with the M-mode using a 8-2 MHz curved array ultrasound probe placed longitudinally in the subcostal region

CombinationCrystalloid

6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride (voluven®) 250 mL will be administered over 5 minutes starting immediately after intrathecal injection

Combination

Ringer acetate 250 mL will be administered over 5 minutes starting immediately after intrathecal injection

Crystalloid

Ringer acetate 500 mL will be administered over 55 minutes following colloid or crystalloid administration

CombinationCrystalloid

After 60 minutes of intrathecal injection, 6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride (voluven®) 250 mL will be administered over 60 minutes

Combination

After 60 minutes of intrathecal injection, Ringer acetate 250 mL will be administered over 60 minutes

Crystalloid

Intravenous ephedrine 3, 5, and 10 mg will be administered when Systolic blood pressure decreases below 120, 110, and 90 mmHg, respectively.

CombinationCrystalloid

Immediately after delivery, syntocinon 10 IU will be added to the running crystalloid solution

CombinationCrystalloid

Eligibility Criteria

Age19 Years - 40 Years
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Preeclampsia: Blood Pressure ≥140/90 mmHg after 20 weeks' gestation and proteinuria ≥300 mg/24 hours or 1+ on urine dipstick
  • Singleton pregnancy
  • Elective cesarean delivery under spinal anesthesia

You may not qualify if:

  • Height \<150 cm
  • Weight \<60 kg
  • Body mass index ≥45 kg/m2
  • Women presenting in labor
  • Contraindications to spinal anesthesia (increased intracranial pressure or local skin infection)
  • Diabetes mellitus, cardiovascular, cerebrovascular, or renal disease
  • Preoperative administration of intravenous hydralazine or magnesium sulphate
  • Hemoglobin \<10 gm/dL
  • International Normalized Ratio \>1.3
  • Platelet count \<100,000 /mm3
  • Preoperative serum creatinine \>1.1 mg/dL

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Anesthesia, Mansoura University Hospitals

Al Mansurah, Dakahlia Governorate, 35511, Egypt

Location

MeSH Terms

Conditions

Pre-Eclampsia

Interventions

Anesthesia, SpinalCesarean Section

Condition Hierarchy (Ancestors)

Hypertension, Pregnancy-InducedPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital Diseases

Intervention Hierarchy (Ancestors)

Anesthesia, ConductionAnesthesiaAnesthesia and AnalgesiaDelivery, ObstetricObstetric Surgical ProceduresSurgical Procedures, Operative

Study Officials

  • Mohamed M Tawfik, MD

    Mansoura University Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Lecturer, Department of anesthesia and surgical intensive care, Primary investigator

Study Record Dates

First Submitted

August 14, 2017

First Posted

August 17, 2017

Study Start

August 19, 2017

Primary Completion

July 15, 2021

Study Completion

July 15, 2021

Last Updated

September 5, 2021

Record last verified: 2021-09

Data Sharing

IPD Sharing
Will not share

Locations