Use of Impedance Cardiography to Decrease the Risk of Pre-eclampsia in Obese Patients

Preeclampsia Clinical Trial

Official title:

Use of Impedance Cardiography to Decrease the Risk of Preeclampsia in Obese Patients

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03105661
• Other study ID #: 4226
• Status: Recruiting
• Phase: Early Phase 1
• Start date: April 4, 2017
• Est. completion date: March 4, 2020

Study information

• Verified date: February 2019
• Source: University of Tennessee Graduate School of Medicine
• Contact: Craig V. Towers, MD
• Phone: 865-305-8888
• Email: ctowers[@]utmck.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

To determine if the use of impedance cardiography can identify appropriate medications for use in treating morbidly obese patients to decrease the risk of preeclampsia.

Description:

Research Protocol

Use of Impedance Cardiography to decrease the risk of preeclampsia in obese patients

Background: Obesity is epidemic in the United States and this is leading to an increase in the number of pregnant patients with obesity. Obesity, especially morbid obesity (BMI >/= 40), increases the risk of developing preeclampsia when compared to the non-obese population. Impedance Cardiography has never been used to evaluate this patient population to see if they have abnormal cardiac output and/or abnormal peripheral resistance. If identified, low dose medical treatment can be done to normalize these patterns early on to see if this treatment modality decreases the development of preeclampsia and other pregnancy complications.

Specific Aims: The primary aim of this study is to determine if the use of Impedance Cardiography can help identify the appropriate medicine for use in treating morbidly obese patients that have abnormal testing results, to see if by normalizing impedance cardiography testing parameters results in a decrease in the incidence of preeclampsia in general and other pregnancy complications.

Enrollment: All pregnant patients, 18-51 years old, less than 20 weeks pregnant, with a BMI >/= 40 will undergo impedance cardiography and if the results are abnormal, will be provided informed consent to participate. If consent is given, and blood pressure is < 140/90,they will be eligible for enrollment.

Randomization: All patients who meet criteria will undergo impedance cardiography. Those with abnormal results will be randomized as the whether they will be treated or not. Randomization will require they blindly pull a paper labelled "yes" or "no" from a container. Those who select "yes" will be randomized to the treatment arm and will be prescribed antihypertensive medications commonly used in obstetrics for hypertension (labetalol, nifedipine, atenolol) Those who select "no" will not receive medication.

Study Procedure: All pregnant patients that meet study criteria and have abnormal Impedance Cardiography testing will be asked to participate, consented and randomized to the treatment or non treatment arm. The treatment group will receive antihypertensive medications as listed above and undergo monthly cardiography testing after beginning treatment with medication adjustments until normal test results are obtained. The non treatment group will undergo repeat cardiography testing 8 weeks after the first test to compare results. All enrolled patients will be followed with regular prenatal care for their prospective conditions and followed closely for the development of high or low blood pressure and preeclampsia.

Adverse events: Adverse events related to this study are minimal because the test is non invasive and complications for Impedance Cardiology are non existent. In addition, the drugs used to treat hypertension have been used in obstetrics for over 30 years with good results and minimal problems.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 400
• Est. completion date: March 4, 2020
• Est. primary completion date: December 31, 2019
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 51 Years

Eligibility

Inclusion Criteria:

• Pregnant patients 18-51 years old,

• Less than 20 weeks gestation with Morbid Obesity (BMI >/= 40)

• Not on antihypertensive medications

Exclusion Criteria:

• Patients with an allergy to antihypertensive medication or contraindication for their usage such as certain cardiac or neurologic disorder during pregnancy

• Patients who have a blood pressure 140/90 or greater

Related Conditions & MeSH terms

• Obesity, Morbid
• Pre-Eclampsia
• Preeclampsia

Intervention

Drug:
• Labetalol Hydrochloride 200 mg
Anti-hypertensive prescribed for increased cardiac output as determined by Impedance Cardiography
• NIFEdipine 60 mg
Anti-hypertensive medication prescribed for increased systemic vascular resistance as determined by Impedance Cardiography
• Atenolol 25 mg
Anti-hypertensive prescribed for increased cardiac output with tachycardia or maternal pulse rate 110 or greater

Locations

Country	Name	City	State
United States	University of Tennessee Medical Center	Knoxville	Tennessee

Sponsors (1)

Lead Sponsor	Collaborator
University of Tennessee Graduate School of Medicine

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Rates of preeclampsia in morbidly obese pregnant women	Rates of preeclampsia in morbidly obese pregnant women	2 years