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Trial registered on ANZCTR
Registration number
ACTRN12614001236684
Ethics application status
Approved
Date submitted
17/11/2014
Date registered
26/11/2014
Date last updated
23/11/2018
Date data sharing statement initially provided
23/11/2018
Date results provided
23/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
What is the failure rate of extending epidural analgesia to anaesthesia for emergency caesarean section in women with a body mass index greater than 40 compared with women with a body mass index < 30? A prospective cohort study.
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Scientific title
In pregnant women with a body mass index greater than 40, is epidural extension for emergency caesarean section more likely to fail, compared with women with a body mass index less than 30?
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Secondary ID [1]
285205
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obesity in pregnancy
292821
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Condition category
Condition code
Anaesthesiology
293115
293115
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0
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Anaesthetics
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Reproductive Health and Childbirth
293116
293116
0
0
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Childbirth and postnatal care
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Diet and Nutrition
293877
293877
0
0
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Obesity
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Exposure is body mass index > 40 or body mass index <30. the primary outcome is the success or failure of use of their epidural for their anaesthetic for caesarean section. The outcome will be measured at the time of caesarean section.
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Intervention code [1]
290079
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Not applicable
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Comparator / control treatment
The group with a BMI<30 is considered to be the control group
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Control group
Active
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Outcomes
Primary outcome [1]
292982
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The rate of failure to extend an existing labour epidural to successful anaesthesia for caesarean section, described as an odds ratio. Failure will be defined as:
1. use of an alternative neuraxial technique
2. general anaesthesia was administered:
a) as a pre-operative decision, before skin incision
b) as an intra-operative decision, after skin incision
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Assessment method [1]
292982
0
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Timepoint [1]
292982
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Time of anaesthesia for caesarean section
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Primary outcome [2]
293606
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Use of the labour epidural as the anaesthetic technique
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Assessment method [2]
293606
0
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Timepoint [2]
293606
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At time of anaesthesia for caesarean section
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Secondary outcome [1]
310073
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Secondary outcome measures: Demographic data, details of antenatal care, co-morbidities, insertion of the labour epidural and anaesthetic management for caesarean section will be collected in order to determine potential predictors of extension failure
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Assessment method [1]
310073
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Timepoint [1]
310073
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Before and during anaesthesia for caesarean section
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Eligibility
Key inclusion criteria
Antenatal BMI greater than 40 after the 30 week of pregnancy
Intending to have vaginal delivery
Utilise epidural analgesia.
Require Category 1 or 2 caesarean section (according to RANZCOG7 criteria).
Women in the control group (BMI less than 30) will meet the same criteria.
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Minimum age
15
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Age less than 15 years, age greater than 45 years, acute haemorrhage or sepsis identified prior to delivery, known intrauterine fetal death prior to delivery, failure to attend one antenatal appointment, cardiovascular disease with New York Heart Association (NYHA) classification >3, respiratory disease with NYHA >3, SEVERE cognitive impairment, SEVERE mental illness, SEVERE intellectual disability
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Study design
Purpose
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Data from a pilot study conducted at the RBWH, using identical definitions, were used in calculating the sample size. Assuming a failure rate of 0.159 in the control group, the study group will require 100 participants with 200 control participants, to detect an odds ratio of 2.27 (alpha equals 0.05 and beta equals 0.8). Recruiting from two sites it may be estimated that full data collection may take three years.
The primary outcome measure will be analysed using Chi-square statistic. Demographic and baseline data will be presented as frequencies/percent for categorical data or means/standard deviations for continuous data. Multiple logistic regression will be used to determine significant predictors of extension failure.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/03/2015
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Actual
2/03/2015
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Date of last participant enrolment
Anticipated
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Actual
13/03/2017
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Date of last data collection
Anticipated
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Actual
13/03/2017
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Sample size
Target
300
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Accrual to date
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Final
300
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment postcode(s) [1]
8631
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4006 - Herston
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Recruitment postcode(s) [2]
8632
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4101 - South Brisbane
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Recruitment postcode(s) [3]
15638
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4114 - Logan City
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Funding & Sponsors
Funding source category [1]
290258
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Hospital
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Name [1]
290258
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The Royal Brisbane and Women's Hospital
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Address [1]
290258
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Butterfield St
Herston 4006
QLD
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Country [1]
290258
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Brisbane and Women's Hospital
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Address
Butterfield St
Herston 4006
QLD
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Country
Australia
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Secondary sponsor category [1]
288964
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None
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Name [1]
288964
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nil
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Address [1]
288964
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nil
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Country [1]
288964
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
291552
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Queensland Health Central Office
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Ethics committee address [1]
291552
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15 Butterfield St Herston 4006 QLD
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Ethics committee country [1]
291552
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Australia
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Date submitted for ethics approval [1]
291552
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07/08/2014
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Approval date [1]
291552
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21/08/2014
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Ethics approval number [1]
291552
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HREC/14/QHC/36
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Summary
Brief summary
Pregnant women with a body mass index (BMI) > 40 may be recommended to have an epidural inserted early in labour. One reason given, is to avoid a general anaesthetic. However a pilot study showed that these women are 2.47 times more likely to receive an alternated technique. This study aims to compare the use of epidurals at caesarean section in women with a BMI > 40, with the use in women with a BMI <30. The results may affect the advice given to obese women in the antenatal period and change their anaesthetic management.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
50846
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Dr Victoria Eley
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Address
50846
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Department of Anaesthesia and Perioperative Medicine
The Royal Brisbane and Women's Hospital
Butterfield St, Herston 4006
QLD
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Country
50846
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Australia
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Phone
50846
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+61 7 3646 1775
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Fax
50846
0
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Email
50846
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[email protected]
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Contact person for public queries
Name
50847
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Victoria Eley
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Address
50847
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Department of Anaesthesia and Perioperative Medicine
The Royal Brisbane and Women's Hospital
Butterfield St, Herston 4006
QLD
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Country
50847
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Australia
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Phone
50847
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+61 7 3646 1775
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Fax
50847
0
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Email
50847
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[email protected]
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Contact person for scientific queries
Name
50848
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Victoria Eley
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Address
50848
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Department of Anaesthesia and Perioperative Medicine
The Royal Brisbane and Women's Hospital
Butterfield St, Herston 4006
QLD
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Country
50848
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Australia
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Phone
50848
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+61 7 3646 1775
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Fax
50848
0
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Email
50848
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Consent not provided
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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