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Ringer's Lactate Versus Normal Saline in Caesarean Section

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ClinicalTrials.gov Identifier: NCT01585740
Recruitment Status : Completed
First Posted : April 26, 2012
Last Update Posted : June 14, 2012
Sponsor:
Information provided by (Responsible Party):
Faculty of Medicine, Makerere University

Brief Summary:

The objective of this study is to compare the effect on mean maternal and neonatal pH, and 24-hour postoperative morbidity, following intraoperative infusion of Ringer's Lactated versus normal saline in caesarean section at Mulago Hospital.

The null hypothesis is that intraoperative infusion of Ringer's Lactate in caesarean section at Mulago Hospital will not result in 30% less mean maternal and neonatal pH change than intraoperative infusion of normal saline.


Condition or disease Intervention/treatment Phase
Normal Anion Gap Metabolic Acidosis Drug: 0.9% Normal Saline Drug: Ringer's Lactate Not Applicable

Detailed Description:

Fluid therapy in caesarean section surgery in Mulago Hospital is done mostly with 0.9% normal saline (NS). Several studies have highlighted the complications associated with large infusion of normal saline. Few studies have compared the effects of an alternative crystalloid, Ringer's Lactate (RL), on perinatal pH and postoperative morbidity in caesarean section surgery.

This trial will be performed in Mulago Hospital Labour Ward theatre on parturients who consent and are scheduled for either elective or emergency caesarean section under spinal anaesthesia from September 2011 to May 2012. Study fluid will be administered intraoperatively only. Preoperative and postoperative venous blood samples will be drawn for venous blood gases, serum urea and creatinine. Placental umbilical arterial cord blood will also be drawn for neonatal arterial blood gases. Mothers will be followed up for 24 hours for incidence of postoperative morbidity.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 500 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Effect of Ringer's Lactate on Maternal and Neonatal pH in Caesarean Section at Mulago Hospital, a Randomized Trial
Study Start Date : September 2011
Actual Primary Completion Date : April 2012
Actual Study Completion Date : May 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Cesarean Section

Arm Intervention/treatment
Active Comparator: Normal Saline
250 patients in this arm assigned to receive normal saline as the study fluid
Drug: 0.9% Normal Saline
Crystalloid fluid
Other Name: Normal saline

Active Comparator: Ringer's Lactate
250 patients in this arm assigned to receive Ringer's Lactate as the study fluid
Drug: Ringer's Lactate
Crystalloid fluid
Other Names:
  • Lactated Ringer's
  • Hartmann's Solution




Primary Outcome Measures :
  1. Change in Maternal pH from preoperative baseline [ Time Frame: Intraoperatively ]
    The aim is to study the effect of the study fluid on maternal pH. pH will be measured preoperatively and immediately postoperatively before the patient leaves the recovery room.


Secondary Outcome Measures :
  1. Neonatal pH [ Time Frame: Within 30 seconds of umbilical cord ligature ]
    A sample of umbilical arterial cord blood will be drawn after ligating the cord to measure neonatal pH

  2. Change in maternal base excess from preoperative baseline [ Time Frame: Intraoperatively ]
    The aim is to study the effect of the study fluid on maternal base excess. Base excess will be measured preoperatively and immediately postoperatively before the patient leaves the recovery room.

  3. Number of mothers with postoperative morbidity events [ Time Frame: 24 hours postoperatively ]
    Using a Post-Operative Morbidity Survey (POMS) mothers will be followed up postoperatively for 24 hours assessing incidence of morbidity in the following systems: Pulmonary, Renal, Gastrointestinal, Cardiovascular, Neurological, and Hematological.



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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • All parturients who consent for the study.
  • Up to American Society of Anesthesiology (ASA) class ІІ/E.

Exclusion Criteria:

  • Failed spinal anaesthesia that has to be converted to general anaesthesia.

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): NCT01585740


Locations
Uganda
Mulago Hospital Labour Suite Operating Theatre
Kampala, Uganda
Sponsors and Collaborators
Makerere University
Investigators
Principal Investigator: Emmanuel T Ayebale, Anaesthesia Makerere University

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Faculty of Medicine, Dr. Emmanuel Timarwa Ayebale, Makerere University
ClinicalTrials.gov Identifier: NCT01585740     History of Changes
Other Study ID Numbers: FluidObs-1
First Posted: April 26, 2012    Key Record Dates
Last Update Posted: June 14, 2012
Last Verified: June 2012

Keywords provided by Faculty of Medicine, Makerere University:
Hyperchloraemic metabolic acidosis
Neonatal acidosis
Neonatal hyperchloraemia
Base excess
Metabolic acidosis
Caesarean section
Normal saline
Ringer's Lactate
Postoperative morbidity

Additional relevant MeSH terms:
Acidosis
Acid-Base Imbalance
Metabolic Diseases