Hypotension Prediction Index to Predict Epidural-labor Analgesia Induced Hypotension

Hypotension Prediction Index to Predict Epidural-labor Analgesia Induced Hypotension -- Pilot Study

The purpose of this pilot trial is to examine the feasibility and ease of use of monitoring by ClearSight in laboring and delivering patients with the intent to compare time-to-treatment of hypotension between conventionally monitored patients (Group CM) and those receiving HPI (Group CM + HPI) monitoring by ClearSight, in a population of healthy laboring women who receive epidural analgesia.

In a prospective study, we will achieve the following aims:

To determine the feasibility and ease of use of the ClearSight monitoring system in the labor-delivery room (LDR) in detecting and monitoring hypotensive events post-epidural labor analgesia placement.

To compare the Time-to-Treatment of hypotensive events between the conventionally monitored patients (Group CM) and those receiving HPI (Group CM + HPI) monitoring by ClearSight.

Inclusion Criteria:

• Pregnant
• Age ≥ 18 years of age
• Planning vaginal delivery
• Receiving epidural labor analgesia (ELA)

Exclusion Criteria:

• Non-reassuring fetal tracing at the time of ELA request
• Contraindications to ELA
• Significant cardiac arrhythmias or aortic regurgitation
• Arrhythmia
• Treatment with antihypertensive medications
• Pre-eclampsia with or without severe features
• Preoperative infection
• Inability to use ClearSight device for any reason
• Non-English fluency
• Sustains unintentional dural puncture
• Incomplete data