What is the failure rate of extending epidural analgesia to anaesthesia for emergency caesarean section in women with a body mass index greater than 40 compared with women with a body mass index < 30? A prospective cohort study.

In pregnant women with a body mass index greater than 40, is epidural extension for emergency caesarean section more likely to fail, compared with women with a body mass index less than 30?

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12614001236684

Enrollment

300

Registered

2014-11-26

Start date

2015-03-02

Completion date

2017-03-13

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Pregnant women with a body mass index (BMI) > 40 may be recommended to have an epidural inserted early in labour. One reason given, is to avoid a general anaesthetic. However a pilot study showed that these women are 2.47 times more likely to receive an alternated technique. This study aims to compare the use of epidurals at caesarean section in women with a BMI > 40, with the use in women with a BMI <30. The results may affect the advice given to obese women in the antenatal period and change their anaesthetic management.

Interventions

Exposure is body mass index > 40 or body mass index <30. the primary outcome is the success or failure of use of their epidural for their anaesthetic for caesarean section. The outcome will be measured at the time of caesarean section.

Eligibility

Sex/Gender

All

Age

15 Years to 45 Years

Healthy volunteers

Inclusion criteria

Antenatal BMI greater than 40 after the 30 week of pregnancy Intending to have vaginal delivery Utilise epidural analgesia. Require Category 1 or 2 caesarean section (according to RANZCOG7 criteria). Women in the control group (BMI less than 30) will meet the same criteria.

Exclusion criteria

Age less than 15 years, age greater than 45 years, acute haemorrhage or sepsis identified prior to delivery, known intrauterine fetal death prior to delivery, failure to attend one antenatal appointment, cardiovascular disease with New York Heart Association (NYHA) classification >3, respiratory disease with NYHA >3, SEVERE cognitive impairment, SEVERE mental illness, SEVERE intellectual disability

Outcome results