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Maternal Lateral Tilt and Cardiac Output in Caesarean Section

Sponsored by Fondazione Policlinico Universitario Agostino Gemelli IRCCS

About this trial

Last updated 4 years ago

Study ID

LUD-CS

Status

Completed

Type

Observational

Placebo

No

Accepting

18-75 Years
18+ Years
Female
Female

Not accepting

Not accepting
Healthy Volunteers

Trial Timing

Ended 5 years ago

What is this trial about?

Background: Left uterine displacement (LUD) has been questioned as an effective strategy to prevent aortocaval compression after spinal anesthesia (SA) for cesarean delivery (CD). The investigators tested if LUD has a significant impact on cardiac output (CO) in patients undergoing CD under SA during continuous non-invasive hemodynamic monitoring. Methods: Forty-six patients were included in the final analysis. The investigators considered 4 timepoints of 5 minutes each: T1=baseline with LUD; T2=baseline without LUD; T3=after SA with LUD; T4=after SA without LUD. LUD was then repositioned for CD. Primary outcome was to test if CO decreased from T3 to T4. We also compared CO between T1 and T2 and other hemodynamic variables: mean, systolic and diastolic blood pressure (respectively MAP, SAP and DAP), heart rate (HR), stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), contractility (dP/dt), dynamic arterial elastance (Eadyn) at the different timepoints. Data on fetal Apgar scores and umbilical arterial and venous pH were collecte

What are the participation requirements?

Yes

Inclusion Criteria

- pregnant patients at term (36th to 40th week of gestation) scheduled for elective caesarean section under spinal anesthesia.

No

Exclusion Criteria

- age <18 years

- American Society of Anesthesiologists score >3

- cardiac arrhythmias or aortic regurgitation

- pregnancy-induced hypertension

- pre-eclampsia

- body mass index (BMI) > 35 kg/m2

- foetal complications

- coagulation disorders or contraindication to neuraxial block

- emergency surgery

- preoperative infection

- patient's refusal

Locations

Location

Status