Ultrasound Assessment of Gastric Volume in High-Risk Pregnant Women At Term

NCT ID: NCT06803225

Last Updated: 2025-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-03-01

Study Completion Date

2025-11-01

Brief Summary

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The risk of pulmonary aspiration of gastric contents remains a significant risk during anesthesia, especially in pregnant women, as they may often require surgery without having observed appropriate fasting. A bedside ultrasound assessment of the status of the gastric content would be of great value for the clinician.

This prospective observational study aimed to (1) qualitatively and quantitatively describe the sonographic appearance of the gastric antrum in fasted high-risk pregnant women during the third trimester and (2) evaluate the relationship between demographic and clinical variables and the gastric antral cross-sectional area (CSA).

Detailed Description

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The aim of this prospective study is to provide a qualitative and quantitative description of the sonographic appearance of the gastric antrum in fasted high-risk pregnant women in the 3rd trimester.

The investigators expect that the information obtained from the systematic ultrasonographic qualitative/quantitative assessment of the gastric content may help anesthesiologist to better assess aspiration risk and guide anesthetic and airway management, particularly in pregnant women scheduled for elective Cesarean delivery after standard preoperative fasting guidelines.

Conditions

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Pregnancy Respiratory Aspiration of Gastric Content

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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Two-dimensional portable ultrasound unit with a low frequency (2-5 MHz) curved array transducer

Two-dimensional portable ultrasound unit with a low frequency (2-5 MHz) curved array transducer

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Non-labouring pregnant women at 3rd trimester (≥ 28 weeks)
2. 18 years or older.
3. ASA physical status I-III
4. Hospitilized in High Risk Pregnancy Department
5. Ability to understand the rationale of the study assessments and provide signed informed consent.
6. Written informed consent

Exclusion Criteria

1. Patients with American Society of Anesthesiology (ASA) physical status class IV.
2. Patient age \< 18 years
3. Pregnant patients with upper gastrointestinal (GI) disease and pathology.
4. History of upper GI tract surgical procedures.
5. History of medications that affect gastrointestinal motility.
6. Inability to understand the rationale of the study assessments and provide signed informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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The Chaim Sheba Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Maxim Glebov

Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Maxim Glebov Dr Maxim Glebov, MD

Role: CONTACT

Phone: +972585893324

Email: [email protected]

References

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Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available.

Reference Type BACKGROUND
PMID: 26580836 (View on PubMed)

Perlas A, Arzola C, Van de Putte P. Point-of-care gastric ultrasound and aspiration risk assessment: a narrative review. Can J Anaesth. 2018 Apr;65(4):437-448. doi: 10.1007/s12630-017-1031-9. Epub 2017 Dec 11.

Reference Type BACKGROUND
PMID: 29230709 (View on PubMed)

Roukhomovsky M, Zieleskiewicz L, Diaz A, Guibaud L, Chaumoitre K, Desgranges FP, Leone M, Chassard D, Bouvet L; AzuRea, CAR'Echo Collaborative Networks. Ultrasound examination of the antrum to predict gastric content volume in the third trimester of pregnancy as assessed by MRI: A prospective cohort study. Eur J Anaesthesiol. 2018 May;35(5):379-389. doi: 10.1097/EJA.0000000000000749.

Reference Type BACKGROUND
PMID: 29210844 (View on PubMed)

Zieleskiewicz L, Bouvet L, Einav S, Duclos G, Leone M. Diagnostic point-of-care ultrasound: applications in obstetric anaesthetic management. Anaesthesia. 2018 Oct;73(10):1265-1279. doi: 10.1111/anae.14354. Epub 2018 Jul 26.

Reference Type BACKGROUND
PMID: 30047997 (View on PubMed)

Kruisselbrink R, Gharapetian A, Chaparro LE, Ami N, Richler D, Chan VWS, Perlas A. Diagnostic Accuracy of Point-of-Care Gastric Ultrasound. Anesth Analg. 2019 Jan;128(1):89-95. doi: 10.1213/ANE.0000000000003372.

Reference Type BACKGROUND
PMID: 29624530 (View on PubMed)

Smith I, Kranke P, Murat I, Smith A, O'Sullivan G, Soreide E, Spies C, in't Veld B; European Society of Anaesthesiology. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011 Aug;28(8):556-69. doi: 10.1097/EJA.0b013e3283495ba1.

Reference Type BACKGROUND
PMID: 21712716 (View on PubMed)

Dean G, Jacobs AR, Goldstein RC, Gevirtz CM, Paul ME. The safety of deep sedation without intubation for abortion in the outpatient setting. J Clin Anesth. 2011 Sep;23(6):437-42. doi: 10.1016/j.jclinane.2011.05.001. Epub 2011 Aug 9.

Reference Type BACKGROUND
PMID: 21831622 (View on PubMed)

D'Angelo R, Smiley RM, Riley ET, Segal S. Serious complications related to obstetric anesthesia: the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2014 Jun;120(6):1505-12. doi: 10.1097/ALN.0000000000000253.

Reference Type BACKGROUND
PMID: 24845921 (View on PubMed)

Neelakanta G, Chikyarappa A. A review of patients with pulmonary aspiration of gastric contents during anesthesia reported to the Departmental Quality Assurance Committee. J Clin Anesth. 2006 Mar;18(2):102-7. doi: 10.1016/j.jclinane.2005.07.002.

Reference Type BACKGROUND
PMID: 16563326 (View on PubMed)

MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946 Aug;52:191-205. doi: 10.1016/s0002-9378(16)39829-5. No abstract available.

Reference Type BACKGROUND
PMID: 20993766 (View on PubMed)

Other Identifiers

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1346-24-SMC

Identifier Type: -

Identifier Source: org_study_id