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Our aim is to investigate whether a novel landmark, the groove between the buttocks or the intergluteal cleft, can facilitate the identification of the neuraxial midline in obstetric patients when compared to ultrasound as the reference standard for the determination of this midline
Determine if the intergluteal cleft, when compared to ultrasound as the reference standard, can be used to identify the neuraxial midline in obstetric patients
Difference in horizontal distance between the vertical lines of the intergluteal cleft and the neuraxial midline, the latter measured with ultrasound
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group | Each patient will be requested to adopt a standardised upright position. First, two of the investigators will use a spirit level ruler and ink pen to agree upon and visibly mark the horizontal intercristal line on the back of the patient. Second, investigator B will leave the room, and investigator A will make a vertical mark with an ultraviolet pen denoting the intersection of the inferior aspect of the intergluteal cleft and the horizontal intercristal line. Third, investigator A will then leave the room, and investigator B will return to the room to make a vertical mark with an ink pen representing the intersection of the neuraxial midline, as established with the transverse spinous process view on ultrasound, and the horizontal intercristal line. After these two vertical marks have been made at the level of the intercristal line, the horizontal distance between them will be measured in mm by these same two investigators |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intergluteal Cleft | Diagnostic Test | Marking of intersection between inferior aspect of the intergluteal cleft and the horizontal intercristal line |
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| Measure | Description | Time Frame |
|---|---|---|
| Horizontal distance between intergluteal cleft and neuraxial midline | One horizontal distance and hence one primary outcome | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in horizontal distance stratified by body mass index | Variation for BMI and recorded data | 12 months |
| Difference in horizontal distance stratified by presence of pre-eclampsia | Variation for pre-ecalmpsia and recorded data |
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Inclusion criteria
Exclusion criteria
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Pregnant patients
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| Name | Affiliation | Role |
|---|---|---|
| Gill Arbane, BSc | Guys' & St Thomas' NHS Foundation Trust | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Guy's Hospital, Great Maze Pond | London | London | SE1 9RT | United Kingdom |
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| Neuraxial Midline | Diagnostic Test | Marking of intersection between the neuraxial midline, as established with the transverse spinous process view on ultrasound, and the horizontal intercristal line |
|
| Horizontal Distance between Vertical Markings | Diagnostic Test | The horizontal distance between these two vertical marks will be measured at the level of the intercristal line |
|
| 12 months |
| Difference in horizontal distance stratified by presence of pregnancy induced hypertension | Variation for pregnancy induced hypertension a and recorded data | 12 months |