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Coagulation Profile Surrounding Normal Cesarean Delivery

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ClinicalTrials.gov Identifier: NCT02482246
Recruitment Status : Completed
First Posted : June 26, 2015
Last Update Posted : December 2, 2015
Sponsor:
Information provided by (Responsible Party):
University of Chicago

Brief Summary:
Healthy parturients presenting for scheduled cesarean delivery will have blood drawn and measured for microparticles at baseline, immediately after delivery, and at several time points thereafter.

Condition or disease
Pregnancy

Detailed Description:

Protocol: Informed consent will be obtained and documented. Subjects who agree to participate will have an intravenous line of at least 16 gauge placed by an anesthesiologist via standard sterile technique, and lidocaine will be used for patient comfort during the procedure. The intravenous line will contain two stopcocks and will be connected to intravenous fluids as ordered by the obstetrician or anesthesiologist for patient care. If for any reason the intravenous line cannot be used for blood draws, a second intravenous line will be placed for the purpose of drawing blood samples. This line will be placed by an anesthesiologist who uses lidocaine and operates under standard sterile conditions. This line will not be connected to fluids, but to a device with a short piece of tubing used commonly for this purpose (often called a "heplock," although no heparin is used); two stopcocks will be attached to the end of this device.

Blood samples will be drawn through the intravenous line (or the "heplock" when it becomes necessary to place one) using the following procedure: a 10 mL sterile syringe will be attached to the distal stopcock and 5 mL of blood will be withdrawn (to clear the line of intravenous fluids). A second 10 mL sterile syringe will be attached to the proximal stopcock and 5 mL blood will be withdrawn for assay (total 10 mL blood withdrawn). The blood withdrawn to clear the line will be wasted. Finally, a 5 mL normal saline flush will be administered to clear the line of blood.

Blood will be drawn at baseline (placement of intravenous catheter), immediately after delivery of the placenta (within 15 minutes), 1 hour postpartum (within 1 hour and 1 hour 15 minutes), 4 hours postpartum (within 4 hours and 4 hours 15 minutes), and 24-36 hours postpartum (5 samples total per subject). After the last blood draw, the intravenous line will be discontinued if clinically indicated.

Blood will be placed in a standard "yellow top" tube and sent to the University's flow cytometry lab where it will be centrifuged and will undergo flow cytometry to measure microparticles and staining to identify endothelial-, platelet- versus leukocyte-derived microparticles and to determine placental origin. In addition Tissue Factor levels in the microparticles will be measured. Also, confirmatory image stream microscopy will be performed. Data acquisition will be performed on the ImageStreamX with validation on the Gallios Cytometer.

Demographic data collected will include age, height, weight, American Society of Anesthesiologists Physical Status Classification, gravidity, parity, estimated gestational age, and co-existing maternal or obstetric conditions. Note will be made of the date and time of each blood draw, and date and time of delivery of the baby and the placenta. Estimated blood loss will be recorded, as will blood product transfusion.

Sample size: As this is pilot data, a convenience sample of 10 patients will be studied.

Statistics: Demographic data will be presented primarily with descriptive statistics. Comparisons will be made for each assay result among the various time points (i.e., baseline values compared to values at subsequent times). Tests for normality will be performed; mean and standard deviation will be reported for normal data and median with interquartile range for non-normal data. Assay results at various time points will be compared with a mixed-model analysis of variance. A P < 0.05 will be required to reject the null hypothesis.


Study Type : Observational
Actual Enrollment : 10 participants
Observational Model: Case-Only
Time Perspective: Prospective
Official Title: Coagulation Profile Surrounding Normal Cesarean Delivery
Study Start Date : January 2014
Actual Primary Completion Date : December 2014
Actual Study Completion Date : June 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Cesarean Section




Primary Outcome Measures :
  1. Change in Microparticle number and type [ Time Frame: Baseline, delivery, and 1-hr, 4-hr and 24-36-hr post delivery ]
    Assay of withdrawn blood


Biospecimen Retention:   Samples Without DNA
Blood


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Pregnant women
Criteria

Inclusion Criteria:

  • All patients with a singleton pregnancy with gestational age greater than or equal to 36 weeks who present for scheduled cesarean delivery will be eligible for participation.

Exclusion Criteria:

  • Specific exclusion criteria include emergency cesarean delivery, labor pain, hypertensive diseases of pregnancy, diabetes, known placental abnormalities such as placental abruption, placenta previa and placenta accreta, and known disorders of coagulation or recent anticoagulant therapy.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02482246


Locations
United States, Illinois
University of Chicago
Chicago, Illinois, United States, 60637
Sponsors and Collaborators
University of Chicago

Responsible Party: University of Chicago
ClinicalTrials.gov Identifier: NCT02482246     History of Changes
Other Study ID Numbers: IRB12-1260
First Posted: June 26, 2015    Key Record Dates
Last Update Posted: December 2, 2015
Last Verified: December 2015