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CompletedNCT02684513Updated Jul 31, 2019

Impact of Oral Carbohydrate Consumption Prior to Cesarean Section

An interventional study of Oral Carbohydrate Beverage and Rehydration beverage in Dehydration, sponsored by University of Florida. Completed at 1 site in United States. Open to female participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-07-31.

Sponsored by University of Florida · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
134
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Female
01

Study summary

For more than 15 years, traditional fasting regimens prior to scheduled surgeries have been called into question, yet prolonged preoperative fasting remains common practice. While prolonged fasting is aimed at reducing the risk of pulmonary aspiration, prolonged fasting is uncomfortable, has an inconsistent effect on gastric volumes and acidity and may lead to dehydration without a clear reduction in the incidence of aspiration. Fasting by itself decreases hepatic glycogen stores, induces a state of insulin resistance and impairs cardiovascular function. Yet, prolonged preoperative fasting remains common.

Preoperative oral carbohydrate (CHO) consumption improves insulin sensitivity and decreases the time to return of gut function without increasing gastric volumes or acidity compared to other clear liquids and fasting. Previous work has shown oral CHO consumption improves patient well-being to a greater degree than placebo drink (water or flavored water) and fasted controls. Oral CHO also outperforms a similar volume of intravenous glucose supplementation. These benefits have reduced hospital stays in a variety of surgical models by as much as 20%. Further, preoperative CHO supplementation improved postoperative patient hunger, thirst, anxiety, fatigue and nausea.

The purpose of this research study is to determine if drinking a high carbohydrate beverage before cesarean section surgery can improve patient well-being, compared to patients who drink a low carbohydrate beverage or fast before surgery.

Read the detailed description

The study hopes to determine if either of two different oral beverages (a higher CHO concentration versus a lower CHO concentration) is superior to routine fasting in terms of preoperative well-being among patients presenting for scheduled cesarean section. Preoperative well-being will be determined by a composite of visual analog scale scores aimed at assessing hunger, thirst, anxiety, fatigue and nausea on the morning of surgery.

Women will be recruited from one of two outpatient obstetric clinics, University of Florida (UF) Health Women's Center - Medical Plaza or UF Health Women's Center. Women presenting for scheduled cesarean section will be provided with an opportunity to participate. Then the women will be randomized into one of three groups: oral carbohydrate beverage (group CHO), re-hydration beverage of an equal volume (group R) or fasted controls (group F). All subjects who consent to participation will have the following recorded: height, weight, age, indication for cesarean section, surgeon, and number of prior cesarean sections.

02

Conditions studied

  • Dehydration

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Keywords

  • Well-being
  • Quality of Recovery
  • Maternal complications
03

In context

Dehydration

204 studies on the registry are indexed under Dehydration; 29 are open to participants now.

This study's enrollment of 134 is above the median of 43 across 147 interventional studies indexed under Dehydration.

Browse Dehydration studies →

Lead sponsor

University of Florida is the lead sponsor of 1,254 studies on the registry; 201 are open to participants now.

Of its 170 completed or terminated interventional studies of FDA-regulated products, 136 (80%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Full-term (≥37 weeks gestation) with singleton gestation
  • Proficient with English language
  • Planning on undergoing scheduled cesarean delivery under neuraxial anesthesia

Exclusion criteria

Exclusion Criteria:

  • Women with pre-gestational or gestational diabetes mellitus or diabetes present prior to pregnancy
  • Women who did not complete a gestational diabetes screening test
  • Women who received steroids within the past 7 days prior to delivery
  • Women who received magnesium sulfate in the setting of hypertensive disorders of pregnancy
  • Women with a history of chronic opioid use
  • Preterm pregnancies
  • Fetuses with congenital abnormalities or growth restriction
  • Multiple gestation
  • Women who are American Society of Anesthesiology Class III or higher
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Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Factorial assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
134 participants (actual)

Study arms

  • Active comparator
    Oral Carbohydrate Beverage Group

    Subjects assigned to this group will receive 710 mL of a preoperative beverage the evening prior to surgery and 355 mL the morning of surgery.

    Dietary Supplement: Oral Carbohydrate Beverage

  • Active comparator
    Rehydration Beverage Group

    Subjects assigned to this group will receive 710 mL of re-hydration beverage the evening prior to surgery and 355 mL the morning of surgery.

    Dietary Supplement: Rehydration beverage

  • No intervention
    Fasted Controls

    Subjects assigned to this group will fast for ≥8 hours prior to surgery.

Interventions

  • Dietary supplementOral Carbohydrate Beverage

    The oral carbohydrate beverage will be consume in a 710 mL amount the evening prior to surgery and then a 355 mL amount the morning of surgery.

    Also known as: Preoperative beverage

  • Dietary supplementRehydration beverage

    The rehydration beverage group will be consume in a 710 mL amount the evening prior to surgery and then a 355 mL amount the morning of surgery.

    Also known as: Preoperative beverage

06

What researchers measure

Primary outcomes

  1. Change in preoperative well-being assessment from baseline to one hour using the 100 millimeter (mm) visual analogue scale.

    100 mm visual analogue scales for hunger, thirst, anxiety, fatigue and nausea administered on the morning of surgery prior to morning beverage consumption and 60 minutes after the beverage. All measurements will be assessed using the same scale starting at 0 to 100mm with 0 being the worst and 100 being the best and average being 85.

    Time frame: Change from baseline to one hour

Secondary outcomes

  1. Changes between the maternal groups assessed by the mean arterial pressure (MAP) recordings in every 5 minute period

    Maternal cardiovascular function will be assessed by using the average of all the mean arterial pressure (MAP) recordings in every 5 minute period. This will be measured by using a student's t-test for significant differences between the groups.

    Time frame: At time of surgery to the conclusion

  2. Number of participants admitted to maternal intensive care unit between the groups

    Number of ICU admissions during hospitalization between the groups

    Time frame: Up to 15 days

  3. Number of days in the hospital for each participant between the groups

    Number of days in the hospital for each participant between the groups. This will be measured by using the chi-square tests to assess the frequency of this outcome between the groups.

    Time frame: Up to 15 days

  4. Number of postoperative infections between the groups

    Number of postoperative infections for each participant between the groups. This will be measured by using the chi-square tests to assess the frequency of this outcome between the groups.

    Time frame: Up to 15 days

  5. Neonates with plasma glucose level of less than 45 mg/dL between the groups

    First umbilical cord blood sample will be taken for plasma glucose level of less than 45 mg/dL to note hypoglycemia between the groups.

    Time frame: Baseline

  6. Number of neonates with a 5 minute Apgar score less than 7 between the groups

    Record of the 5 minute apgar score \< 7. Apgar scores are as follows: between 7 and 10, means the neonate is in good shape, between 4 and 6 may need some help breathing, and 3 or less may need immediate lifesaving measures.

    Time frame: 5 minutes

  7. Number of neonates on ventilation for 6 hours or greater between the groups

    Number of neonates on ventilation for 6 hours or greater will be recorded.

    Time frame: 6 hours

  8. Number of neonates diagnosed with an infection between the groups.

    Number of neonates with an infection diagnosis. This will be measured by using the chi-square tests to assess the frequency of this outcome between the groups.

    Time frame: Baseline

  9. Number of neonates admitted to the intensive care unit (ICU) between the groups

    Number of neonates admitted to the ICU between the groups. This will be measured by using the chi-square tests to assess the frequency of this outcome between the groups.

    Time frame: Baseline

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Study locations

1 site
  • UF Health
    Gainesville, Florida 32610-3003, United States
08

References and documents

Publications

  • Wendling AL, Byun SY, Koenig M, Vasilopoulos T. Impact of oral carbohydrate consumption prior to cesarean delivery on preoperative well-being: a randomized interventional study. Arch Gynecol Obstet. 2020 Jan;301(1):179-187. doi: 10.1007/s00404-020-05455-z. Epub 2020 Feb 5. PubMed 32025843 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 31, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02684513
Lead sponsor
University of Florida
Collaborators
Heermann Anesthesia Foundation
Responsible party
Sponsor
First posted
Feb 18, 2016
Start date
Jun 14, 2016
Primary completion
Jun 12, 2018
Completion
Apr 4, 2019
Last update
Jul 31, 2019

Study contacts

Adam Wendling, MD
principal investigator · University of Florida

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jul 2019. You cannot join it, but the record below documents what was studied.

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