Evaluation of the Effect of Body Mass Index on Gastric Volume With Ultrasound in Term Pregnant Women
| Status: | Recruiting |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/3/2019 |
| Start Date: | May 29, 2018 |
| End Date: | June 15, 2019 |
| Contact: | Efrain Riveros Perez, MD |
| Email: | eriverosperez@augusta.edu |
| Phone: | 7067217361 |
This study seeks to determine if a relationship exists between gastric antrum cross-sectional
area measured using ultrasound and BMI in term pregnant women (>37 weeks gestation).
area measured using ultrasound and BMI in term pregnant women (>37 weeks gestation).
After approval by the Institutional Review Board, the investigators will obtain consent from
patients. The consent will be obtained by the authorized personnel as per protocol, in which
the investigators will explain to the patient the procedure, benefit, risk, cost and,
confidentiality. The investigators plan to get the consent immediately after the patient
arrived at the unit to avoid any interference with the delivery process. If the patient needs
to go to an emergency cesarean section. This patient is not going to be included in the
study. A gastric ultrasound with a low frequency (1-5 Hz) curvilinear array transducer using
a Philips (CX-50) (Bothell, WA. USA) with image compounding technology, will be performed in
each patient. The ultrasound procedure will be performed in the supine position and in a
semi-recumbent right lateral position. The antrum will be identified in the sagittal plane
between the liver, pancreas and aorta between peristaltic contractions. The ultrasound will
be performed in each patient, in each position by three operators: two staff
anesthesiologists and an anesthesia resident in presence of a medical student who will make
sure that the standards for the procedure are uniform between operators (three images will be
recorded by each operator per position in each patient). A qualitative assessment will be
initially made, consisting of three grades: Grade 0, no fluid evidenced; Grade 2, clear fluid
is evidenced only in right lateral decubitus position, and Grade 3, fluid is evidenced in
both positions. Quantitative measurement of the cross-sectional area of the antrum (CSA) will
be done by means of free tracing calipers. The full-thickness of the gastric wall will be
included in the measurement and the average from the three images of each operator will be
recorded. CSA will be calculated using the following formula:
CSA =(π x mean anteroposterior diameter x mean longitudinal diameter)/4
In addition to qualitative and quantitative ultrasound measures, the investigators will
record demographic variables including age, BMI, weeks of gestation, gravity and parity.
The investigators plan to evaluate the existence of a relationship between cross-sectional
area of the antrum (CSA) and BMI in term pregnant women using measurements of the CSA taken
with free tracing calipers in ultrasound
patients. The consent will be obtained by the authorized personnel as per protocol, in which
the investigators will explain to the patient the procedure, benefit, risk, cost and,
confidentiality. The investigators plan to get the consent immediately after the patient
arrived at the unit to avoid any interference with the delivery process. If the patient needs
to go to an emergency cesarean section. This patient is not going to be included in the
study. A gastric ultrasound with a low frequency (1-5 Hz) curvilinear array transducer using
a Philips (CX-50) (Bothell, WA. USA) with image compounding technology, will be performed in
each patient. The ultrasound procedure will be performed in the supine position and in a
semi-recumbent right lateral position. The antrum will be identified in the sagittal plane
between the liver, pancreas and aorta between peristaltic contractions. The ultrasound will
be performed in each patient, in each position by three operators: two staff
anesthesiologists and an anesthesia resident in presence of a medical student who will make
sure that the standards for the procedure are uniform between operators (three images will be
recorded by each operator per position in each patient). A qualitative assessment will be
initially made, consisting of three grades: Grade 0, no fluid evidenced; Grade 2, clear fluid
is evidenced only in right lateral decubitus position, and Grade 3, fluid is evidenced in
both positions. Quantitative measurement of the cross-sectional area of the antrum (CSA) will
be done by means of free tracing calipers. The full-thickness of the gastric wall will be
included in the measurement and the average from the three images of each operator will be
recorded. CSA will be calculated using the following formula:
CSA =(π x mean anteroposterior diameter x mean longitudinal diameter)/4
In addition to qualitative and quantitative ultrasound measures, the investigators will
record demographic variables including age, BMI, weeks of gestation, gravity and parity.
The investigators plan to evaluate the existence of a relationship between cross-sectional
area of the antrum (CSA) and BMI in term pregnant women using measurements of the CSA taken
with free tracing calipers in ultrasound
Inclusion Criteria:
1. Pregnant patients >37 weeks of gestation
2. Age older than 18 years
3. NPO status >6 hours
Exclusion Criteria:
1. Unwillingness to participate in the study
2. Diagnosis of upper gastrointestinal disease
3. Episode of vomiting within the last 6 hours
4. Patients taking gastric pro-kinetic medications
5. Diabetes mellitus
6. Prior gastric, esophageal or upper abdominal surgery
7. Allergy to US gel
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