None listed
Conditions
Brief summary
The prone position is a body position in which a person lies horizontal with the chest down and back up. With appropriate pillows and positioning, it is a safe position for pregnant women and because of this the position is utilised in the allied health fields and for relaxation and massage in pregnant women. In this position uterine compression of the large maternal vessels is alleviated. Yet, despite this, the prone position is rarely used in the medical setting in pregnant women and there is very little information about the position in the medical literature. There is no published information about the prone position in women with hypertension in pregnancy including preeclampsia. We have recently published a new unified theory of preeclampsia. It proposes that the development of hypertension in pregnant women is an adaptive response to the demands of a growing fetus and is driven by an imbalance between maternal oxygen supply to the fetus (which may be caused by inadequate blood flow to the uteroplacental unit) and fetal oxygen demands. When thinking about the prone position in the light of this new theory we hypothesise that placing a pregnant women, with new onset pregnancy associated hypertension, into this position may reduce her blood pressure by eliminating abdominal compression of blood vessels thereby reducing abdominal vascular resistance and improving blood flow. This proposed study aims to test this hypothesis.
Interventions
Women rest in the left lateral position for 5 minutes (timed by one of the study investigators) and then they have haemodynamics, respiratory rate and oxygen saturation measured. The women are then placed in the prone position and rested for 5 minutes (timed by one of the study investigators) and then then have haemodynamics, respiratory rate and oxygen saturation measured. The women then return to the seated or lateral position.
Sponsors
The Royal Womens Hospital Parkville
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
Healthy pregnant women: Healthy term (greater than or equal to 37 weeks gestation) pregnant women will be defined as American Society of Anesthesiologists (ASA) Classification I or II, with no significant medical or surgical illness. Age 18-45 years Women with gestationally acquired hypertension greater than or equal to 20 weeks gestation: Women aged 18-45 years will be included in the study if they meet the diagnostic criteria for either gestational hypertension or preeclampsia.
Exclusion criteria
Healthy pregnant women: current vasoactive medication including salbutamol and thyroxine, pre-existing or gestational diabetes, known cardiovascular disease including chronic disorders that may influence the cardiovascular system such as chronic renal disease, multiple pregnancy, smokers, any woman in labour or postpartum and inability to consent to study. Age < 18, > 45 years Women with gestationally acquired hypertension: Any woman with pre-existing or gestational diabetes, multiple pregnancy, smokers, any woman in labour, any woman with decompensated disease (eclampsia, pulmonary oedema) or postpartum and inability to consent to study, Age < 18, > 45 years
Outcome results
None listed