Pregnancy Clinical Trial
Official title:
Fetal Copeptin After Oxytocin Challenge Test
The relationship of uterine contractions on fetal copeptin levels in umbilical cord blood is studied.
Background: Vaginal delivery evokes a dramatic surge in stress hormones facilitating the
transition of the infant to extra-uterine life. Infants born by elective cesarean section
(C-section) are known to have a higher risk for compromised birth adaptation. Labor is vital
for vaginal delivery and triggers fetal stress hormone release. Fetal plasma copeptin, a
surrogate marker of arginine vasopressin, has been found to be 100 to 1000-fold increased
after vaginal delivery as compared to elective C-section. However, the relationship of labor
intensity and fetal stress hormone release is largely unknown.
Objective: The purpose of this study is to determine fetal copeptin in newborns delivered by
C-section to mothers who had an oxytocin challenge test (OCT) just prior to birth as
compared to those without OCT.
Protocol: Pregnant women at term are eligible to participate if no uterine contractions are
reported within the last 24 hours and no contractions are recorded in cardiotocogram over 30
minutes. Further inclusion and exclusion criteria see below. After written informed consent,
all participants get an infusion line and participants receive OCT or placebo. The OCT is
standardized as follows: 5 IE Syntocinon (oxytocin) in 500 mL Ringer, infusion rate begins
with 12 ml/h and is increased by steps of additional 12 ml/h until three contractions within
ten minutes are recorded. Subsequently, infusion is stopped. The placebo is Ringer infusion
without Syntocinon. C-section is done about 1 to 3 hours after OCT or placebo and arterial
umbilical cord blood is collected at birth. Maternal and newborn data are recorded within
the first few days after birth, including maternal blood loss, neonatal adaptation, and
postnatal weight loss.
;
Observational Model: Case Control, Time Perspective: Cross-Sectional
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