Cesarean Section Complications
Conditions
Brief summary
This study compared the effects of prophylactic infusion of metaraminol, phenylephrine and norepinephrine adjusted according to body weight on fetal acid-base balance and maternal hemodynamics.
Detailed description
At present, the ED90 of metaraminol, phenylephrine, and norepinephrine in the prevention of cesarean section hypotension has been explored. We compare the effects of three drugs on the fetus and mothers at the concentration of ED90 to provide advice on the use of vasoactive drugs for obstetrics anesthesia .
Interventions
DRUGmetaraminol
Infusion of metaraminol adjusted according to body weight to obtain higher pH value of fetal umbilical artery blood.
DRUGPhenylephrine
Infusion of Phenylephrine adjusted according to body weight to obtain higher pH value of fetal umbilical artery blood.
DRUGNorepinephrine
Infusion of Norepinephrine adjusted according to body weight to obtain higher pH value of fetal umbilical artery blood.
Sponsors
Xuzhou Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
1. Singleton pregnancy at term scheduled to be delivered via elective cesarean delivery; 2. height 150-180 cm; 3. American Society of Anesthesiologists (ASA) physical status II-III; 4. body mass index (BMI) \<35 kg/m2.
Exclusion criteria
1. transverse presentation, fetal macrosomia; 2. uterine abnormalities (eg, large fibroids, bicornuate uterus); 3. polyhydramnios; 4. ruptured membranes, oligohydramnios; 5. intrauterine growth restriction; 6. gestational or nongestational hypertension, diabetes, or eclampsia; 7. hypertensive disorders or any condition associated with autonomic neuropathy (such as diabetes mellitus for \>10 years) or renal failure; 8. contraindications for combined spinal-epidural anesthesia; 9. participants who declined to sign informed consent forms.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Umbilical artery blood pH | 30 seconds after delivery | pH value of fetal umbilical artery blood |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| hypotension | Intraoperative | Number of Participants with systolic blood pressure reduction \>20% baseline value or systolic blood pressure \<90 mm Hg before delivery |
| bradycardia | Intraoperative | Number of Participants with heart rate was ≤50 bpm before delivery |
| The incidence of nausea in pregnant women | Intraoperative | Anesthesiologist observes combined patient dictation. |
| Umbilical artery blood base excess | 30sec after delivery | base excess of fetal umbilical artery blood |
| The incidence of vomiting in pregnant women | Intraoperative | Anesthesiologist observes combined patient dictation |
Countries
China
Outcome results
None listed