This is a prospective observational study conducted at the University Hospital of Padua. The goal is to identify ultrasound markers that can help predict whether placing an epidural catheter during labor will be difficult. Pregnant women who request epidural analgesia will undergo a quick ultrasound scan of their lower back before the procedure. The study will collect information such as age, weight, height, and spinal anatomy, as well as ultrasound measurements. This information will be compared with how easy or difficult it was to place the epidural. The study does not involve any experimental treatment and uses standard care procedures already in place. There are no additional risks or costs for participants.
This is a single-center, prospective observational study aimed at evaluating whether specific ultrasound measurements of spinal structures in pregnant women can predict technical difficulty in placing an epidural catheter during labor analgesia. All procedures performed are part of standard care and are routinely offered in the labor and delivery unit. Patients who consent to participate will undergo a lumbar ultrasound prior to epidural catheter placement. Data will be collected regarding anatomical and clinical characteristics, ultrasound findings, and procedural details. The study will run for two years or until the estimated sample size of 563 patients is reached. The results are intended to identify non-invasive predictors of challenging epidural placement, potentially improving patient safety and resource allocation.
Study Type
OBSERVATIONAL
Enrollment
563
Epidural catheter placement for labor analgesia
An ultrasound scan will be performed on the spine to identify anatomical characteristics of potential interest
University Hospital of Padua
Padua, Italy
RECRUITINGIncidence of Difficulty of epidural catheter placement
Defined as the need for more than one puncture attempt (exiting the skin with the needle) or the involvement of a second operator to successfully place the epidural catheter.
Time frame: Periprocedural
Number of puncture attempts
Number of attempts required to successfully insert the epidural catheter.
Time frame: Periprocedural
(Predictor of difficult Epidural) Distance from skin to spinous process at epidural placement level
The distance measured in cm between the skin surface and the spinous process at the intended epidural insertion site, assessed using ultrasound scanning.
Time frame: Periprocedural
(Predictor of difficult Epidural) Distance between spinous processes
Measured in centimeters by ultrasound to assess interspinous space width.
Time frame: Periprocedural
(Predictor of difficult Epidural) Distance from skin to transverse process
Measured in centimeters by ultrasound to assess distance between skin and transverse process.
Time frame: Periprocedural
(Predictor of difficult Epidural) Patient age
Measured in years
Time frame: Baseline
(Predictor of difficult Epidural) Pre-pregnancy weight
Measured in kg
Time frame: Baseline
(Predictor of difficult Epidural) Current weight
Measured in kg
Time frame: Baseline
(Predictor of difficult Epidural) Body Mass Index (BMI)
Measured in kg/cm2
Time frame: Baseline
(Predictor of difficult Epidural) Palpability of spinous processes
Measured as "Yes", "Not completely", "No"
Time frame: Periprocedural
(Predictor of difficult Epidural) Previous spinal surgery
"Yes" or "No" variable. Accounting for any type of vertebral surgery
Time frame: Baseline
(Predictor of difficult Epidural) Presence of scoliosis
"Yes" or "No" variable.
Time frame: Baseline
(Predictor of difficult Epidural) Operator Experience
Operator related. Defined as the number of epidural catheter previously positioned
Time frame: Periprocedural
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