Comparison of Maternal Hemodynamics During Spinal Anesthesia with Different Cesarean Delivery Positioning

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age20-40
SponsorAswan University

About this trial

Cesarean delivery is a common surgical procedure, and maintaining maternal hemodynamic stability during the procedure is crucial for both maternal and fetal outcomes . Hemodynamic instability, such as hypotension following spinal anesthesia, is a frequent complication and can lead to adverse maternal and neonatal outcomes. Traditionally, after spinal anesthesia, women are positioned supine, sometimes with a slight left lateral tilt to mitigate the risk of aortocaval compression . However, recent studies and clinical observations suggest that delayed supine positioning-keeping the patient in a sitting or semi-sitting position for a period following spinal anesthesiamay improve hemodynamic stability. These alternative positions may help to mitigate the abrupt drop in blood pressure commonly seen after spinal anesthesia by allowing for a more gradual redistribution of blood volume . Understanding the optimal positioning strategy could lead to improved clinical protocols that enhance maternal and fetal safety. By comparing immediate supine positioning with delayed supine positioning (in sitting and semi-sitting positions), this study aims to provide evidence on which positioning strategy offers the best hemodynamic outcomes.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Pregnant women scheduled for elective cesarean delivery.

Age between 18 and 40 years.

ASA (American Society of Anesthesiologists) physical status II.

Disqualifiers

Emergency cesarean delivery.

Pre-existing cardiovascular disease.

Severe preeclampsia or eclampsia.

Multiple pregnancies.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Positioninng during Cs

    Behavioral

    1. Group A (N=72): Immediate Supine Position (Control): Immediately after administering spinal anesthesia, participants will be placed in a supine position. To reduce the risk of aortocaval compression, a slight left lateral tilt (approximately 15 degrees) will be applied. This is the traditional positioning method and serves as the control group for comparison. 2. Group В (N=72): Sitting Position: After spinal anesthesia, participants will be positioned in a sitting position with the ack supported at a 90-degree angle for the first 2 minutes. Knees will be bent, and feet will be supported. 3. Group С (N=72): Semi-Sitting Position: After spinal anesthesia, participants will be positioned in a semi-sitting position with the back supported at the back supported at for the first 2 minutes. Similar to the sitting position, knees and feet will be flat.

Treatment groups

216 Participants
are divided into 3 treatment groups
Group A: Group A (N=72): Immediate Supine PositionActive comparator 1 intervention
Group B: Group В (N=72): Sitting PositionExperimental treatment 1 intervention
Group C: Group С (N=72): Semi-Sitting PositionExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

To compare the incidence and severity of hypotension in immediate supine, sitting, and semi-sitting positions during cesarean delivery.

Time frame
9 Months

Secondary outcomes

Other outcomes

Sponsors and contacts

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Aswan University

Lead sponsor

Aswan University Hospital

Collaborator

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