Maternal Hemodynamic, Maternal Positioning During CS, This Study Aims to Provide Evidence on Which Positioning Strategy Offers the Best Hemodynamic Outcomes
Conditions
Brief summary
Cesarean delivery is a common surgical procedure, and maintaining maternal hemodynamic stability during the procedure is crucial for both maternal and fetal outcomes . Hemodynamic instability, such as hypotension following spinal anesthesia, is a frequent complication and can lead to adverse maternal and neonatal outcomes. Traditionally, after spinal anesthesia, women are positioned supine, sometimes with a slight left lateral tilt to mitigate the risk of aortocaval compression . However, recent studies and clinical observations suggest that delayed supine positioning-keeping the patient in a sitting or semi-sitting position for a period following spinal anesthesiamay improve hemodynamic stability. These alternative positions may help to mitigate the abrupt drop in blood pressure commonly seen after spinal anesthesia by allowing for a more gradual redistribution of blood volume . Understanding the optimal positioning strategy could lead to improved clinical protocols that enhance maternal and fetal safety. By comparing immediate supine positioning with delayed supine positioning (in sitting and semi-sitting positions), this study aims to provide evidence on which positioning strategy offers the best hemodynamic outcomes.
Interventions
BEHAVIORALPositioninng during Cs
1. Group A (N=72): Immediate Supine Position (Control): Immediately after administering spinal anesthesia, participants will be placed in a supine position. To reduce the risk of aortocaval compression, a slight left lateral tilt (approximately 15 degrees) will be applied. This is the traditional positioning method and serves as the control group for comparison. 2. Group В (N=72): Sitting Position: After spinal anesthesia, participants will be positioned in a sitting position with the ack supported at a 90-degree angle for the first 2 minutes. Knees will be bent, and feet will be supported. 3. Group С (N=72): Semi-Sitting Position: After spinal anesthesia, participants will be positioned in a semi-sitting position with the back supported at the back supported at for the first 2 minutes. Similar to the sitting position, knees and feet will be flat.
Sponsors
Aswan University Hospital
Aswan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Pregnant women scheduled for elective cesarean delivery. * Age between 18 and 40 years. * ASA (American Society of Anesthesiologists) physical status II.
Exclusion criteria
* Emergency cesarean delivery. * Pre-existing cardiovascular disease. * Severe preeclampsia or eclampsia. * Multiple pregnancies. * Known fetal anomalies.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To compare the incidence and severity of hypotension in immediate supine, sitting, and semi-sitting positions during cesarean delivery. | 9 Months |
Countries
Egypt
Contacts
Primary ContactAhmed Yousef Mohamed, Resident of Anesthesia
Outcome results
None listed