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Early skin to skin contact has beneficial effects and is part of the Healthy Birth Initiative. Positive effects on breast feeding, cardiorespiratory status, blood glucose control, and temperature has been demonstrated. It is the standard of care for vaginal deliveries but surgery is a barrier in its initiation in the operating room. This study is evaluating initiating skin to skin contact as soon as feasible in the operating room. Informed consent will be obtained from scheduled/non emergent cesarean sections who are of EGA.37 weeks who are ASA I-II and receiving the standard spinal anesthetic. Skin to skin contact will be initiated after delivery as soon as apgars and newborn assessment has been completed. Goal is a minimum of 60 minutes of skin to skin contact between the mother and the newborn, with the only interruption being upon movement from the OR table to the stretcher when leaving the OR. Subjects seen post delivery day 1 for assessments of pain and maternal satisfaction utilizing a sliding 100mm VAS assessment tool.
Initiation of skin to skin contact between the mother and the baby will be done in the operating room during surgery rather than waiting until the recovery room as is our standard of care. After assurance that both mom and newborn are stable, the newborn will be placed across the mother's chest and covered with a blanket to help maintain body temperature. The skin to skin contact is maintained throughout the remaining surgical time and then continued into the recovery room. The subjects are seen post delivery day 1 for evaluation of their pain and satisfaction with care using a 0-100mm sliding VAS scale, with 0=not satisfied at all or no pain at all through 100 = total satisfaction and most severe pain ever.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| skin to skin | Experimental | skin to skin initiated on all consented CS while in the operating room |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| skin to skin | Other | initiating skin to skin is not currently the standard of care at our facility so there is 1 interventional arm for this study. control group of no skin to skin until recovery room already established as is the standard of care. |
| Measure | Description | Time Frame |
|---|---|---|
| Maternal Evoked Pain Scores | maternal evoked pain is evaluated utilizing a 100 mm Sliding VAS scale with 0=no pain through 100=most severe pain ever | up to 24 hours |
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| Measure | Description | Time Frame |
|---|---|---|
| Morphine Usage | 24 hour morphine equivalents required in the operating room up to the initial 24 hours after delivery for pain management | up to 24 hours |
| Maternal Satisfaction With Anesthesia Care | maternal satisfaction with anesthesia care will be evaluated on post delivery day 1 utilizing a 100mm sliding scale where VAS 0= not satisfied at all up to 100= extremely satisfied |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ashley Tonidandel, MD | Wake Forest University Health Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Novant Health Forsyth Medical Center | Winston-Salem | North Carolina | 27103 | United States |
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Subjects were approached in the preoperative holding room area regarding participation in this study. Subjects were electively scheduled to have a cesarean delivery with proposed healthy outcomes with term deliveries.
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| ID | Title | Description |
|---|---|---|
| FG000 | Skin to Skin | skin to skin initiated on all consented CS while in the operating room skin to skin: initiating skin to skin is not currently the standard of care at our facility so there is 1 interventional arm for this study. control group of no skin to skin until recovery room already established as is the standard of care. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Skin to Skin | skin to skin initiated on all consented CS while in the operating room skin to skin: initiating skin to skin is not currently the standard of care at our facility so there is 1 interventional arm for this study. control group of no skin to skin until recovery room already established as is the standard of care. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Maternal Evoked Pain Scores | maternal evoked pain is evaluated utilizing a 100 mm Sliding VAS scale with 0=no pain through 100=most severe pain ever | Posted | Mean | Standard Deviation | units on a scale | up to 24 hours |
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24 hours evaluation time period
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Skin to Skin | skin to skin initiated on all consented CS while in the operating room skin to skin: initiating skin to skin is not currently the standard of care at our facility so there is 1 interventional arm for this study. control group of no skin to skin until recovery room already established as is the standard of care. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Ashley Tonidandel, MD | Wake Forest Health Sciences | 336-718-8278 | atonidan@wakehealth.edu |
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| up to 24 hours |
| Maternal Satisfaction With Pain Control in the Operating Room | with pain control in the operating room will be evaluated on post delivery day 1 utilizing a 100mm sliding scale VAS 0= not satisfied at all up to 100= extremely satisfied | 24 hours |
| Maternal Satisfaction With Postoperative Pain Control | with pain control at 24 hours postoperative will be evaluated on post delivery day 1 utilizing a 100mm sliding scale VAS 0= not satisfied at all up to 100= extremely satisfied | 24 hours |
| Maternal Satisfaction-operating Room | maternal satisfaction with operating room atmosphere will be evaluated on post delivery day 1 utilizing a 100mm sliding scale VAS 0= not satisfied at all up to 100= extremely satisfied | 24 hours |
| Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Other Pre-specified | Morphine Usage | 24 hour morphine equivalents required in the operating room up to the initial 24 hours after delivery for pain management | Posted | Mean | Standard Deviation | mg of morphine | up to 24 hours |
|
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| Other Pre-specified | Maternal Satisfaction With Anesthesia Care | maternal satisfaction with anesthesia care will be evaluated on post delivery day 1 utilizing a 100mm sliding scale where VAS 0= not satisfied at all up to 100= extremely satisfied | Posted | Mean | Standard Deviation | units on a scale | up to 24 hours |
|
|
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| Other Pre-specified | Maternal Satisfaction With Pain Control in the Operating Room | with pain control in the operating room will be evaluated on post delivery day 1 utilizing a 100mm sliding scale VAS 0= not satisfied at all up to 100= extremely satisfied | Posted | Mean | Standard Deviation | units on a scale | 24 hours |
|
|
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| Other Pre-specified | Maternal Satisfaction With Postoperative Pain Control | with pain control at 24 hours postoperative will be evaluated on post delivery day 1 utilizing a 100mm sliding scale VAS 0= not satisfied at all up to 100= extremely satisfied | Posted | Mean | Standard Deviation | units on a scale | 24 hours |
|
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| Other Pre-specified | Maternal Satisfaction-operating Room | maternal satisfaction with operating room atmosphere will be evaluated on post delivery day 1 utilizing a 100mm sliding scale VAS 0= not satisfied at all up to 100= extremely satisfied | Posted | Mean | Standard Deviation | units on a scale | 24 hours |
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| 0 |
| 55 |
| 0 |
| 55 |
| 0 |
| 55 |
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