Non-invasive Versus Invasive Blood Pressure Measurement in the Morbidly Obese Parturient With Severe Preeclampsia

NCT ID: NCT03222414

Last Updated: 2019-12-11

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

3 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-01

Study Completion Date

2016-01-18

Brief Summary

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The study will compare agreement of invasive blood pressure measurements with non-invasive blood pressure measurements measured with a conical blood pressure and large standard upper arm rectangular cuff in morbidly obese severely hypertensive (systolic blood pressure \> 160 mmHg) parturients.

Detailed Description

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A morbidly obese \[Body Mass Index (BMI) ≥ 40 kg/m2\] pregnant woman is at singular risk for all the complications of pregnancy, most notably preeclampsia (PE). Furthermore a woman who is already chronically hypertensive is likely to develop superimposed PE . Uncontrolled systolic hypertension in pregnancy prompts placental abruption, hemorrhagic stroke, and systolic or diastolic heart failure. Accurate blood pressure measurement is therefore a prerequisite to controlling dangerously high systolic blood pressure (SBP) to enable labor and delivery to be conducted safely in association with PE. Precise SBP measurement is also a precondition for clinically testing hypotheses concerning the existence of druggable targets that will allow prolongation of pregnancy in the face of severe PE and /or intra-uterine growth restriction (IUGR) remote from term.

Oscillometric noninvasive blood pressure (NIBP) measurement is the customary standard blood pressure monitoring method most often used in the labor suite and obstetric operating room today. For this purpose a rectangular, cylindrical blood pressure (BP) cuff placed on the upper arm is connected to an oscillometric blood pressure device. Yet inaccuracies related to the fact that oscillometric NIBP devices under-read high SBP relative to IBP measurements have been recognized as a potential source of maternal morbidity for years.

The study will compare IBP readings obtained from morbidly obese, severely hypertensive (SBP \> 160 mm Hg) parturients with NIBP consecutively measured with new innovative conical Ultracheck Curve BP cuffs and large standard upper arm rectangular cylindrical BP cuffs.

Conditions

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Pre-Eclampsia Morbid Obesity Parturient Blood Pressure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Arm A: Conical then Cylindrical

BP recording with noninvasive conical Ultracheck Curve BP cuff and direct invasive arterial pressure monitoring; then with traditional cylindrical BP cuff and direct invasive arterial pressure monitoring

Group Type EXPERIMENTAL

Non-invasive BP recording with conical Ultracheck Curve BP cuff

Intervention Type DEVICE

Non-invasive SBP, DAP and MAP will be measured in both arms using conical Ultracheck Curve BP cuff

Non-invasive BP recording with traditional cylindrical BP cuff

Intervention Type DEVICE

Non-invasive SBP, DAP and MAP will be measured in both arms using traditional cylindrical BP cuff

Direct invasive arterial pressure

Intervention Type OTHER

Direct invasive arterial pressure readings will be recorded simultaneously with non-invasive measurements

Arm B: Cylindrical then Conical

BP recording with noninvasive traditional cylindrical BP cuff and direct invasive arterial pressure monitoring; then with conical Ultracheck Curve BP cuff and direct invasive arterial pressure monitoring

Group Type ACTIVE_COMPARATOR

Non-invasive BP recording with conical Ultracheck Curve BP cuff

Intervention Type DEVICE

Non-invasive SBP, DAP and MAP will be measured in both arms using conical Ultracheck Curve BP cuff

Non-invasive BP recording with traditional cylindrical BP cuff

Intervention Type DEVICE

Non-invasive SBP, DAP and MAP will be measured in both arms using traditional cylindrical BP cuff

Direct invasive arterial pressure

Intervention Type OTHER

Direct invasive arterial pressure readings will be recorded simultaneously with non-invasive measurements

Interventions

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Non-invasive BP recording with conical Ultracheck Curve BP cuff

Non-invasive SBP, DAP and MAP will be measured in both arms using conical Ultracheck Curve BP cuff

Intervention Type DEVICE

Non-invasive BP recording with traditional cylindrical BP cuff

Non-invasive SBP, DAP and MAP will be measured in both arms using traditional cylindrical BP cuff

Intervention Type DEVICE

Direct invasive arterial pressure

Direct invasive arterial pressure readings will be recorded simultaneously with non-invasive measurements

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Written, signed and dated informed consent
* ≥ 18 years of age
* BMI \>40 kg/m2
* Has a clinically indicated radial artery line already in situ or who agree to placement of an arterial line
* Systolic blood pressure \>160 mm Hg
* Gestational age greater than or equal to 24 weeks
* Parturients admitted for induction of labor

Exclusion Criteria

* Parturients admitted in labor
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Laura Sorabella

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Laura Sorabella, M.D.

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

References

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Ashworth DC, Maule SP, Stewart F, Nathan HL, Shennan AH, Chappell LC. Setting and techniques for monitoring blood pressure during pregnancy. Cochrane Database Syst Rev. 2020 Jul 23;8(8):CD012739. doi: 10.1002/14651858.CD012739.pub2.

Reference Type DERIVED
PMID: 32748394 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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150606

Identifier Type: -

Identifier Source: org_study_id