Supine Versus Left Lateral Tilted Position During Cesarean Delivery

Cairo University (CU)

Status and phase: Unknown; Phase 4

Conditions: Cesarean Section Complications

Treatments: Drug: Bupivacaine; Other: left lateral tilted position; Other: supine position

Study type: Interventional

Funder types: Other

Identifiers

NCT03182114

N-52-2017

Details and patient eligibility

About

In this study, we will investigate the effect of left lateral tiling performed after spinal block on maternal hemodynamics compared to ordinary supine position

Full description

Maternal hypotension is a common complication after spinal anesthesia for cesarean delivery (CD). Aortocaval compression is one of the theoretical mechanisms precipitating for post-spinal hypotension (PSH) for CD. Positioning of the patients in the left lateral tilted position after preforming spinal block was frequently considered a standard protocol for minimizing aortocaval compression and improve maternal hemodynamics during CD; however, the latest Cochrane database review reported that there is no adequate evidence to support any positioning protocol for prevention of PSH. Moreover, a recent study was conducted in full term pregnant women reporting no improvement in cardiac output with left lateral tilting. In this study, the effect of left lateral tiling performed after spinal block on maternal hemodynamics will be compared to ordinary supine position.

Enrollment: 450 estimated patients

Sex: Female

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• full term
• singleton pregnant women
• scheduled for elective cesarean delivery

Exclusion criteria

• Cardiac morbidities
• hypertensive disorders of pregnancy
• peripartum bleeding
• baseline systolic blood pressure (SBP) < 100 mmHg
• body mass index > 35

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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450 participants in 2 patient groups, including a placebo group

supine position

Placebo Comparator group

Description:

the patient will receive spinal anesthesia by Bupivacaine; then she will be placed in supine position

Treatment:

Other: supine position

Drug: Bupivacaine

Left lateral tilted position

Experimental group

Description:

the patient will receive spinal anesthesia by Bupivacaine; then she will be placed in left lateral tilted position

Treatment:

Other: left lateral tilted position

Drug: Bupivacaine