Preeclampsia Severe Clinical Trial
— PANDAOfficial title:
Preeclampsia And Nonsteroidal Drugs for Analgesia (PANDA): a Randomized Non Inferiority Trial
A randomized non-inferiority trial of women with preeclampsia with severe features to determine if the addition of nonsteroidal anti-inflammatory drugs is inferior or non-inferior to standard analgesic bundles in their impact on postpartum hypertension.
Status | Recruiting |
Enrollment | 286 |
Est. completion date | June 1, 2025 |
Est. primary completion date | January 31, 2025 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | N/A and older |
Eligibility | Inclusion Criteria: - Women at > 23 weeks gestational age undergoing vaginal or cesarean delivery at Barnes-Jewish Hospital with: - An antepartum diagnosis of preeclampsia with severe features - Pre-eclampsia with severe features will be defined as: - Elevated blood pressure = 160/110, or - Pre-eclampsia in the setting of thrombocytopenia (platelet count < 100,000), or - Impaired liver function (AST elevated to twice upper limit of normal), or - Persistent epigastric pain, or - Renal insufficiency (serum creatinine of 1.1 mg/dl or doubling of prior value), or - Pulmonary edema, or - New onset visual disturbance or headache unresponsive to therapy. Exclusion Criteria: - NSAID allergy - Allergy to acetaminophen - Antihypertensive use in this pregnancy prior to 20 weeks gestation - Chronic kidney disease or Acute kidney injury with Creatine clearance less than 60 mL/min - Inability to obtain consent - Opioid abuse disorder - Peptic ulcer disease. |
Country | Name | City | State |
---|---|---|---|
United States | Barnes Jewish Hospital | Saint Louis | Missouri |
Lead Sponsor | Collaborator |
---|---|
Washington University School of Medicine |
United States,
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013 Nov;122(5):1122-1131. doi: 10.1097/01.AOG.0000437382.03963.88. No abstract available. — View Citation
Lo JO, Mission JF, Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Curr Opin Obstet Gynecol. 2013 Apr;25(2):124-32. doi: 10.1097/GCO.0b013e32835e0ef5. — View Citation
Mogos MF, Salemi JL, Spooner KK, McFarlin BL, Salihu HH. Hypertensive disorders of pregnancy and postpartum readmission in the United States: national surveillance of the revolving door. J Hypertens. 2018 Mar;36(3):608-618. doi: 10.1097/HJH.0000000000001594. — View Citation
Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005 Feb 26-Mar 4;365(9461):785-99. doi: 10.1016/S0140-6736(05)17987-2. — View Citation
Viteri OA, England JA, Alrais MA, Lash KA, Villegas MI, Ashimi Balogun OA, Chauhan SP, Sibai BM. Association of Nonsteroidal Antiinflammatory Drugs and Postpartum Hypertension in Women With Preeclampsia With Severe Features. Obstet Gynecol. 2017 Oct;130(4):830-835. doi: 10.1097/AOG.0000000000002247. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | postpartum antihypertensive requirements | measurement of anti-hypertensive requirements at time of discharge | at the end of hospitalization, up to 7 days after randomization | |
Secondary | Postpartum pain scores | Evaluate the effect of NSAIDs on patient perception of pain | From randomization to 6 weeks after randomization | |
Secondary | Postpartum opioid use | Compare the opioid requirements in each arm | From randomization to 6 weeks after randomization | |
Secondary | Mean arterial blood pressure | Compare peak, average and median MAPs postpartum | From randomization to 6 weeks after randomization | |
Secondary | End organ damage | Evaluate for evidence of renal, hepatic or neurological injury in the poatpartum period | during hospitalization, an average of 4 days | |
Secondary | Hospital readmission | Evaluate the incidence of hospital readmission rate postpartum | From randomization to 6 weeks after randomization | |
Secondary | Continued anti-hypertensive requirement | evaluate the need for antihypertensive medications at 6 weeks postpartum | up to 6 weeks |
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