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NCT06921473 | NOT YET RECRUITING | Acidosis, Lactic


Effect of Ephedrine vs. Norepinephrine on Prevention of Fetal Acidosis During Cesarean Section Under Spinal Anesthesia
Sponsor:

Mehmet Özkılıç

Information provided by (Responsible Party):

Mehmet Özkılıç

Brief Summary:

This study compares the effects of two medications, ephedrine and norepinephrine, on the baby (fetus) when used to treat low blood pressure (hypotension) during cesarean section under spinal anesthesia. Hypotension is a common side effect during spinal anesthesia, and it can affect the blood flow to the baby. Both medications are commonly used to manage this condition. The goal of the study is to determine which medication is more effective and safer for the baby, by measuring the pH level in the umbilical artery after birth. The study will also examine maternal blood pressure, heart rate, and the baby's Apgar scores.

Condition or disease

Acidosis, Lactic

Hypotension After Spinal Anesthesia

Cesarean Delivery Affecting Newborn

Intervention/treatment

Norepinephrine

Ephedrine

Phase

PHASE4

Detailed Description:

This is a prospective, randomized, double-blind, controlled clinical trial designed to compare the effects of ephedrine and norepinephrine on fetal acidosis during cesarean section performed under spinal anesthesia. Maternal hypotension is a frequent complication associated with spinal anesthesia, and the management of this condition is critical for maintaining adequate uteroplacental perfusion. While both ephedrine and norepinephrine are commonly used vasopressors, there is ongoing debate regarding their relative safety and efficacy, particularly in terms of fetal outcomes. The primary aim of this study is to evaluate the incidence of fetal acidosis, defined as an umbilical artery pH \< 7.20, in patients receiving either ephedrine or norepinephrine. Secondary outcomes include maternal blood pressure control, heart rate, incidence of maternal and fetal tachycardia, Apgar scores at 1 and 5 minutes, and the need for additional vasopressor support. A total of 100 pregnant women undergoing elective cesarean section will be enrolled, with 50 participants in each treatment group. All participants will receive standardized spinal anesthesia, and vasopressors will be titrated according to protocol. The study is designed to inform clinical decision-making regarding optimal vasopressor selection in obstetric anesthesia, with a focus on balancing maternal hemodynamic stability and fetal well-being.

Study Type : INTERVENTIONAL
Estimated Enrollment : 100 participants
Masking : SINGLE
Masking Description : No other parties are masked in this study.
Primary Purpose : PREVENTION
Official Title : Effect of Ephedrine and Norepinephrine on Fetal Acidosis During Cesarean Section Under Spinal Anesthesia: A Prospective, Randomized Controlled Trial
Actual Study Start Date : 2025-06-01
Estimated Primary Completion Date : 2026-01-12
Estimated Study Completion Date : 2026-03-01

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 18 Years to 45 Years
Sexes Eligible for Study: FEMALE
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Pregnant women aged between 18 and 45 years
  • * Singleton pregnancy at ≥ 37 weeks of gestation
  • * Scheduled for elective cesarean section under spinal anesthesia
  • * ASA (American Society of Anesthesiologists) physical status classification I or II
  • * Ability to understand and sign the informed consent form
Exclusion Criteria
  • * History of allergy or hypersensitivity to ephedrine or norepinephrine
  • * Multiple gestation pregnancies
  • * Diagnosis of pre-eclampsia, eclampsia, or other hypertensive disorders of pregnancy
  • * Known cardiovascular disease or arrhythmia
  • * Placental abnormalities (e.g., placenta previa, placental abruption)
  • * Fetal structural or chromosomal anomalies
  • * Morbid obesity (BMI \> 40 kg/m²)
  • * Refusal to participate or inability to provide informed consent

Effect of Ephedrine vs. Norepinephrine on Prevention of Fetal Acidosis During Cesarean Section Under Spinal Anesthesia

Location Details

NCT06921473


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