Study of Blood Flow Changes in Uterine and Umbilical Arteries Before and After Combined Spinal-Epidural Pain Relief in Laboring Women

What this Trial Is About

Researchers are investigating how combined spinal-epidural CSE analgesia affects blood flow in the uterine and umbilical arteries of women in labor. This study focuses on understanding the possible causes of fetal heart rate changes, such as fetal bradycardia, which can occur in 15-30% of cases after CSE. The aim is to evaluate maternal and fetal blood flow changes before and after CSE, using ultrasound measurements of velocimetric indices. The study involves using ultrasound scans to measure blood flow in the umbilical artery at various times before and after CSE analgesia during labor. Participants include women in active labor with singleton pregnancies, both with and without hypertensive disorders. The blood flow will be monitored at baseline, and then at 5, 10, 20, and 30 minutes after CSE administration. The study is non-randomized and open-label. Participants will undergo ultrasound evaluations to assess blood flow changes and complete pain score questionnaires at set intervals during labor. Researchers will monitor fetal heart rate, uterine contractions, maternal blood pressure, and oxygen levels. Neonatal outcomes like weight and Apgar scores will also be recorded. The study will last up to 24 hours after delivery, with follow-up assessments focused on maternal and fetal circulation and pain control during labor.

Changes in Velocimetric Indices of Uterine and Umbilical Arteries Before and After Combined Spinal-epidural Analgesia in Laboring Women (PART II)