Spinal Analgesia Versus No Analgesia: Study for External Cephalic Version - Full Text View

Purpose

The purpose of this study is to examine whether spinal anesthesia affects the chances of successful external cephalic version (ECV) of a breech presenting fetus.

Two study groups will be included; one will receive spinal anesthesia, the other will not. The non-spinal group will be permitted to cross over if ECV procedure is painful.

The main outcome is success of ECV.

Condition	Intervention	Phase
Breech Presentation	Procedure: External cephalic version with and without spinal anesthesia	Phase I

MedlinePlus related topics:

Anesthesia

ChemIDplus related topics:

Bupivacaine Bupivacaine hydrochloride

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Randomized, Open Label, Active Control, Crossover Assignment, Efficacy Study

Official Title:	A Prospective Randomized Study to Examine the Success Rate of External Cephalic Version for Breech Presentation at Term Presentation: Spinal Analgesia Versus No Analgesia

Further study details as provided by Hadassah Medical Organization:

Primary Outcome Measures:

Conversion of a breech to a vertex presentation [ Time Frame: 4-6 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Complications associated with ECV: Premature rupture of membranes, Contractions, Placental abruption, Fetal distress, Pain score during procedure (VAS Scale 0 = no pain, 10 = severe pain). [ Time Frame: 4-6 years ] [ Designated as safety issue: Yes ]
Complications associated with analgesia: Severe maternal hypotension (>20 reduction in systolic BP), Fetal distress (prior to performance of ECV), Post Dural Puncture Headache, Failure of analgesia. [ Time Frame: 4-6 years ] [ Designated as safety issue: Yes ]
Inability to perform procedure due to maternal distress or discomfort. [ Time Frame: 4-6 years ] [ Designated as safety issue: No ]
Mode of delivery and date from the ECV. [ Time Frame: 4-6 years ] [ Designated as safety issue: No ]

Estimated Enrollment:	140
Study Start Date:	October 2002
Study Completion Date:	May 2008
Primary Completion Date:	March 2006 (Final data collection date for primary outcome measure)

Intervention Details:

7.5 mg bupivacaine intrathecally

Show Detailed Description

Eligibility

Ages Eligible for Study:	18 Years to 45 Years
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

ASA I-II
37 + weeks gestation
No previous attempt at ECV in this pregnancy
No fetal abnormality

Exclusion Criteria:

No previous uterine surgery
Any contraindication for vaginal delivery
Contra-indications to regional analgesia: uncorrected hypovolemia, coagulopathy (including anti-coagulants but not low-dose [100mg] aspirin), infection or inflammation of the skin overlying the lumbar area, raised intra-cranial pressure, hypersensitivity to amide local anesthetic agents.
Patient refusal for regional analgesia
Previous history of meningitis, neuropathy, or severe back pain with neurological radiation
Poor communication (no Hebrew or English spoken, deafness, blindness, serious intellectual impairment or psychiatric disorder)
Morbid obesity

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00119184

Locations


Israel
	Hadassah Hebrew University Medical Center
	Jerusalem, Israel, 12000

Sponsors and Collaborators

Hadassah Medical Organization

Investigators


Principal Investigator:	Carolyn F Weiniger, MB ChB	Dept Anesthesiology, Hadassah Hebrew University Medical School

More Information

Publications indexed to this study:

Weiniger CF, Ginosar Y, Elchalal U, Sharon E, Nokrian M, Ezra Y. External cephalic version for breech presentation with or without spinal analgesia in nulliparous women at term: a randomized controlled trial. Obstet Gynecol. 2007 Dec;110(6):1343-50.

Responsible Party:	Hadassah HMO ( Dr Carolyn Weiniger )
Study ID Numbers:	20-25/01/02-HMO-CTIL
First Received:	July 3, 2005
Last Updated:	June 5, 2008
ClinicalTrials.gov Identifier:	NCT00119184
Health Authority:	Israel: Israeli Health Ministry Pharmaceutical Administration

Keywords provided by Hadassah Medical Organization:

anesthesia

breech

external cephalic version

spinal

success

anesthesia,spinal

Study placed in the following topic categories:

Pregnancy Complications

Obstetric Labor Complications

Bupivacaine

Breech Presentation

ClinicalTrials.gov processed this record on August 20, 2008

Sponsored by:	Hadassah Medical Organization
Information provided by:	Hadassah Medical Organization
ClinicalTrials.gov Identifier:	NCT00119184