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Not yet recruitingNCT06803225Updated Jan 31, 2025

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

An observational study in Pregnancy and Respiratory Aspiration of Gastric Content, sponsored by The Chaim Sheba Medical Center. Not yet recruiting. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-01-31.

Sponsored by The Chaim Sheba Medical Center · Observational

Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
500
Ages
18 Years and older
Sex
Female
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Study summary

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).

Read the detailed description

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.

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Conditions studied

  • Pregnancy
  • Respiratory Aspiration of Gastric Content
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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Fasted (6h solids, 2h fluids) high-risk pregnant women at 3rd trimester

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

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.
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Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
500 participants (estimated)
Patient registry
No

Interventions

  • Diagnostic testTwo-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

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What researchers measure

Primary outcomes

  1. Qualitative assessment of the antrum of the stomach

    Patients will be classified as follows; Grade 0: the antrum appears empty on both supine and right lateral decubitus positions; grade 1: gastric fluid is visible on the right lateral decubitus position only, suggesting a small fluid volume; and grade 2: gastric fluid is observed in the antrum in both supine and right lateral decubitus, suggesting a larger fluid volume.

    Time frame: 10 min

Secondary outcomes

  1. Quantitative assessment of the antrum of the stomach

    Three consecutive measures of the CSA (cross sectional area) of the antrum will be calculated via the ultrasound machine (free tracing method).

    Time frame: 10 min

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Study locations

No study locations are listed for this record.

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References and documents

Publications

  • 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. PubMed 26580836 ↗
  • 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. PubMed 29230709 ↗
  • 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. PubMed 29210844 ↗
  • 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. PubMed 30047997 ↗
  • 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. PubMed 29624530 ↗
  • 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. PubMed 21712716 ↗
  • 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. PubMed 21831622 ↗
  • 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. PubMed 24845921 ↗
  • 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. PubMed 16563326 ↗
  • 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. PubMed 20993766 ↗

Individual participant data

Plan to share: No — We do not plan to share individual participant data due to a specific request from our institution, which prioritises maintaining the confidentiality and privacy of patient information. The hospital's data-sharing policies and regulatory constraints are designed to safeguard sensitive health data and prevent potential risks of participant re-identification, even after anonymisation.

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Registry details

Key details

Study ID
NCT06803225
Lead sponsor
The Chaim Sheba Medical Center
Responsible party
Maxim Glebov (Dr., The Chaim Sheba Medical Center) — Principal investigator
First posted
Jan 31, 2025
Start date
Mar 1, 2025 (estimated)
Primary completion
Aug 1, 2025 (estimated)
Completion
Nov 1, 2025 (estimated)
Last update
Jan 31, 2025

Study contacts

Maxim Glebov Dr Maxim Glebov, MD
Contact
hlebau@gmail.com
+972585893324

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Dec 2024. You cannot join it, but the record below documents what was studied.

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