In-vitro Myometrial Contractility After Oxytocin Pre-exposure in Women With Advanced Maternal Age and Morbid Obesity

• Status: Completed
• Trial end date: 2017-06-13
• Target enrollment: 0
• Participant gender: Female

Summary

Women with advanced maternal age and morbid obesity, have a higher incidence of labor induction/ augmentation and cesarean section (CS), and are at a greater risk for postpartum hemorrhage (PPH). Oxytocin is the first line drug in the treatment of PPH, however, oxytocin receptor (OTR) desensitization has been recognized in the context of prolonged labors secondary to either endogenous or exogenous oxytocin exposure. It is unknown if oxytocin desensitization specifically affects contractility in women with advanced maternal age and morbid obesity when compared to younger or normal weight populations. Further it is not known if the higher incidence of PPH seen in these women is due to poor uterine contractility and/or poor response to oxytocin.

The investigators hypothesize that women with advanced maternal age and morbid obesity will exhibit poor myometrial contractility as compared to women that are younger and of normal body habitus, in both oxytocin pre-treated and untreated myometrium.

• Phase: N/A
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Samuel Lunenfeld Research Institute, Mount Sinai Hospital
• Treatments: Oxytocin

Criteria

Inclusion Criteria:

• patients who give written informed consent

• patients requiring elective primary or 1st repeat Cesarean section

• patients with gestational age 37-41 weeks

• non-labouring patients, not exposed to exogenous oxytocin

• Cesarean section under spinal anesthetic

• patients <30 years of age with a normal pre-pregnancy BMI (20 and 24.9 kg/m2)

• patients ≥40 years of age with a normal pre-pregnancy BMI

• patients with a BMI≥40 kg/m2 and age <30 years

Exclusion Criteria:

• patients who refuse to give written informed consent

• patients who require general anesthesia

• patients who have had more than one previous uterine surgery/CS

• patients with placental abnormalities (abruption, accreta, percreta)

• patients with bleeding disorders

• presence of any other risk factors for PPH