Elective Cesarean Section Clinical Trial
Official title:
Observational Pilot Study of the Effect of Intravenous Saline or Pentastarch on Coagulation in Women Having an Elective Cesarean Section
Verified date | February 2008 |
Source | University of British Columbia |
Contact | n/a |
Is FDA regulated | No |
Health authority | Canada: Health Canada |
Study type | Interventional |
Pregnant women are more likely to form clots than non-pregnant women as pregnancy increases
the clotting factors present in the blood. This helps to prevent excess bleeding
(hemorrhage) at the time of delivery. Hemorrhage occurs in 5-15% of pregnancies throughout
the world, even when delivery is by cesarean section. When hemorrhage occurs the
anesthesiologist will normally administer fluids into the woman's vein (intravenously)
rapidly to replace the blood that the woman has lost. Two types of fluids are commonly used.
One is a salt water solution (saline) and the other is a starch water solution
(pentastarch). Use of either or both of these solutions is common during hemorrhage.
These same solutions (salt water solution and starch solution) are used at BC Women's
Hospital during spinal anesthesia to prevent and treat low blood pressure (a common side
effect of spinal anesthesia). This is standard practice whether you are in this study or
not. You may also be given, depending on the anesthesiologist's preference, a drug
(vasopressor) that causes the blood vessels to become narrow (constrict) to prevent or treat
the low blood pressure. Whether you agree to be part of the study or not, your
anesthesiologist will be watching your blood pressure closely throughout your operation and
if your blood pressure becomes low he/she will treat it as is normally done.
Low blood pressure will also occur during hemorrhage. It is therefore important that we
determine whether the starch solution, which is more effective than the salt solution in
preventing low blood pressure during spinal anesthesia, does or does not affect clotting.
Research in non-pregnant adults (male and female) has found that laboratory tests of blood
clotting change with these solutions. For saline the evidence in some studies suggests that
the blood may clot better than normal while other studies suggest the opposite (does not
clot as well). In pregnant and non-pregnant adults the blood does not clot as well with
certain starch solutions. The starch solution used at BC Women's Hospital is called
pentastarch and no research has looked at its effect on clotting in pregnant women. In
non-pregnant adults pentastarch has less effect on clotting than other starch solutions.
The purpose of the study is to see how pentastarch (starch solution) and normal saline
(water with salt in it) given at the time of spinal anesthesia for elective cesarean section
affect the ability of pregnant woman's blood to clot.
Status | Completed |
Enrollment | 30 |
Est. completion date | February 2008 |
Est. primary completion date | February 2008 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: - aged 19 years or over - having an elective cesarean section under spinal anesthesia - at least 36 weeks gestation - in general good health Exclusion Criteria: - blood does not clot normally - taking heparin or AspirinĀ® (acetylsalicylic acid) within 7 days of surgery - high blood pressure - expecting twins - any heart abnormality (including heart failure) - kidney or liver disease - known allergy to hydroxyethylstarch, corn, starch or any drugs - insulin dependent diabetes - aged less than 19 years - do not understand English - having emergency surgery |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Canada | BC Women's Hospital | Vancouver | British Columbia |
Lead Sponsor | Collaborator |
---|---|
University of British Columbia | Children's & Women's Health Centre of British Columbia |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | TEG (clotting) parameters at baseline, 5 minutes & 90 minutes post-infusion | During surgery | Yes | |
Secondary | Changes in INR, APTT and estimated blood loss | During surgery | Yes |
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