Comparison of Maternal Hemodynamics During Spinal Anesthesia with Different Cesarean Delivery Positioning

Aswan University

Status: Not yet enrolling

Conditions: Maternal Positioning During CS; Maternal Hemodynamic; This Study Aims to Provide Evidence on Which Positioning Strategy Offers the Best Hemodynamic Outcomes

Treatments: Behavioral: Positioninng during Cs

Study type: Interventional

Funder types: Other

Identifiers

NCT06857162

966/9/24

Details and patient eligibility

About

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.

Enrollment: 216 estimated patients

Sex: Female

Ages: 20 to 40 years old

Volunteers: Accepts Healthy Volunteers

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.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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216 participants in 3 patient groups

Group A (N=72): Immediate Supine Position

Active Comparator group

Treatment:

Behavioral: Positioninng during Cs

Group В (N=72): Sitting Position

Experimental group

Treatment:

Behavioral: Positioninng during Cs

Group С (N=72): Semi-Sitting Position

Experimental group

Treatment:

Behavioral: Positioninng during Cs