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PregnancyPhase 4NCT05033041

Gastric Volumes by US in Term Parturients Undergoing CS With and Without Metoclopramide

A Phase 4 study testing Study drug metoclopramide in people with Pregnancy and Cesarean Section, run by Northwestern University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Our objective is to compare gastric volumes (mL) between women who receive metoclopramide versus placebo prior to scheduled cesarean delivery in appropriately fasted patients. If metoclopramide is found not to reduce gastric volumes this would inform future practice guidelines for obstetric anesthesia, which currently… Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Pregnancy, Cesarean Section, Aspiration
What is being tested?
Study drug metoclopramide
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
72 participants
Where
1 siteUnited States
Study dates
20 Oct 2021to 8 Feb 2024
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Healthy (ASA Physical Status 2)
  • Age >18 years old
  • Non-obese (BMI <40 kg/m2)
  • Age >18 years
  • Term (>37 week)
  • Non-laboring parturient
  • Single gestation
  • Scheduled for a cesarean delivery and NPO

Who cannot join

  • Systemic disease such as diabetes mellitus (type 1 or 2)
  • Multiple gestation
  • Abnormality of upper GI tract
  • History of GI tract related surgical procedures
  • Use of gastric motility medications
  • Active labor
Show all 11Show fewer
  • Renal impairment (creatinine >2)
  • Non-English speaking
  • Cognitively impaired
  • History of QT prolongation
  • Use of general anesthesia

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Northwestern Memorial Hospital and Prentice Women's Hospital

    Chicago, Illinois, 60611

Other trials in United States

About this study

Official title: Comparison of Gastric Volumes by Gastric Ultrasound in Term Parturients Undergoing Scheduled Elective Cesarean Delivery With and Without Metoclopramide

Our objective is to compare gastric volumes (mL) between women who receive metoclopramide versus placebo prior to scheduled cesarean delivery in appropriately fasted patients. If metoclopramide is found not to reduce gastric volumes this would inform future practice guidelines for obstetric anesthesia, which currently recommends metoclopramide administration prior to cesarean deliveries.

We hypothesize that metoclopramide given to women with appropriate fasting prior to cesarean delivery does not result in any clinically significant reduction in gastric volume (mL) and therefore does not provide any additional benefit for aspiration prophylaxis but may expose patients to unnecessary side effects. A secondary objective will be to evaluate if gastric volume is a significant predictor of intraoperative nausea and vomiting.

Being tested
Study drug metoclopramide, Study drug placebo administration
Keywords
Pregnancy, Gastric Volume, Ultrasound Measurement, Aspiration Prevention, Cesarean Section

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Study drug metoclopramideDrug

    Intravenous administration of 10 mg metoclopramide

  • Study drug placebo administrationDrug

    Intravenous administration of placebo (sterile normal saline)

Study groups in NCT05033041
Study groupRoleWhat they receive
Group 1 Study Drug MetoclopramideActive comparatorIntravenous administration of 10 mg metoclopramide
Receives: Drug: Study drug metoclopramide
Group 2 Study Drug PlaceboPlacebo comparatorIntravenous administration of sterile normal saline
Receives: Drug: Study drug placebo administration

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Gastric Volume (mL)

    Change in gastric volume (mL) determined by gastric ultrasound before and 30 minutes after administration of study drug. Gastric volumes were calculated from the cross sectional area (CSA) area using both the Perlas (Volume=27.0+14.6*(RLD CSA (cm2)-1.28 * age)) and the Roukhomovsky method (volume=(0.18*RLD CSA (mm2))+(0.11*SUP CSA (mm2)-62.4) methods.

    Measured: 30 minutes after administration of study drug

Secondary outcomes (14)
  1. Subject Report of Nausea During Cesarean Section

    Subject reported intraoperative nausea during the cesarean delivery

    Measured: 24 hours

  2. Adverse Events

    Number of reported adverse events experienced for each group.

    Measured: 72 hours

  3. Intraoperative Nausea Occurrences

    Number of nausea occurrences during cesarean section procedure

    Measured: 24 hours

  4. Intraoperative Nausea Time From Intrathecal Anesthesia to Nausea Episode in Minutes

    Total elapsed time in minutes from the placement of the intrathecal medications by anesthesiology team to the first experience of nausea reported by the participant.

    Measured: 24 hours

  5. Subject Experienced Vomiting During Cesarean Section

    Subject experienced vomiting episode during the cesarean delivery procedure.

    Measured: 24 Hours

  6. Number of Intraoperative Vomiting Occurrences

    Number of intraoperative vomiting occurrences during the cesarean section.

    Measured: 24 Hours

  7. Time From Intrathecal Anesthesia to Vomiting Episode in Minutes.

    The elapsed time in minutes from anesthesia team placing the intrathecal medications to the first episode of vomiting during.

    Measured: 24 Hours

  8. Antiemetic Prophylaxis

    Subject received antiemetic prophylaxis of ondansetron or dexamethasone prior to the cesarean section.

    Measured: 24 Hours

  9. PACU Antiemetic Treatment (n)

    Number of participants who required antiemetic medications in the post anesthesia care unit

    Measured: 24 hours

  10. Nausea After PACU Discharge

    Number of participants who experienced nausea after being discharged from the post anesthesia care unit

    Measured: 72 hours

  11. Elapsed Time From Study Drug to Second Ultrasound

    Total elapsed time in minutes after study drug administered to second gastric ultrasound.

    Measured: 24 hours

  12. Second Ultrasound Cross Sectional Area (cm^2)

    The cross sectional area in centimeters squared for the second gastric ultrasound which was performed 30 minutes after study medication administered

    Measured: 24 hours

  13. Post Treatment Estimated Volume (mL) Second Ultrasound

    Gastric volume in milliliters of the second ultrasound obtained 30 minutes after study drug administration

    Measured: 24 hours

  14. Second Ultrasound Volume >1.5 * Weight (kg)

    Number of subjects experiencing a volume greater than than 1.5 times weight in kilograms after the second gastric ultrasound 30 minutes after study medication administration.

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Sep 2021
  2. Study start20 Oct 2021
  3. Primary completion30 Jan 2024
  4. Study completion8 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized controlled blinded study
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
72 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05033041
Sponsor's protocol ID
STU00215570
Status last verified
Aug 2025
First submitted
27 Aug 2021
Last updated
11 Sep 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452. No abstract available.

    PubMed 28045707
  • MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946 Aug;52:191-205. doi: 10.1016/s0002-9378(16)39829-5. No abstract available.

    PubMed 20993766
  • Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available.

    PubMed 26580836
  • 4. Knight M, Bunch K, Tuffnell D, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers' Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016-18. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2020.

  • Leus M, van de Ven A. IMAGES IN CLINICAL MEDICINE. An Acute Dystonic Reaction after Treatment with Metoclopramide. N Engl J Med. 2015 Oct;373(14):e16. doi: 10.1056/NEJMicm1412207. No abstract available.

    PubMed 26422744
  • Mishriky BM, Habib AS. Metoclopramide for nausea and vomiting prophylaxis during and after Caesarean delivery: a systematic review and meta-analysis. Br J Anaesth. 2012 Mar;108(3):374-83. doi: 10.1093/bja/aer509. Epub 2012 Feb 3.

    PubMed 22307240
  • Paranjothy S, Griffiths JD, Broughton HK, Gyte GM, Brown HC, Thomas J. Interventions at caesarean section for reducing the risk of aspiration pneumonitis. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD004943. doi: 10.1002/14651858.CD004943.pub3.

    PubMed 20091567
  • Perlas A, Mitsakakis N, Liu L, Cino M, Haldipur N, Davis L, Cubillos J, Chan V. Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination. Anesth Analg. 2013 Feb;116(2):357-63. doi: 10.1213/ANE.0b013e318274fc19. Epub 2013 Jan 9.

    PubMed 23302981
  • Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. Br J Anaesth. 2014 Jul;113(1):12-22. doi: 10.1093/bja/aeu151. Epub 2014 Jun 3.

    PubMed 24893784
  • Arzola C, Perlas A, Siddiqui NT, Carvalho JCA. Bedside Gastric Ultrasonography in Term Pregnant Women Before Elective Cesarean Delivery: A Prospective Cohort Study. Anesth Analg. 2015 Sep;121(3):752-758. doi: 10.1213/ANE.0000000000000818.

    PubMed 26097988
  • Arzola C, Perlas A, Siddiqui NT, Downey K, Ye XY, Carvalho JCA. Gastric ultrasound in the third trimester of pregnancy: a randomised controlled trial to develop a predictive model of volume assessment. Anaesthesia. 2018 Mar;73(3):295-303. doi: 10.1111/anae.14131. Epub 2017 Dec 19.

    PubMed 29265187
  • Lu SF, McCarthy RJ, Toledo P, Thomas CL, Gaston IN, Samworth AG, Ripchik PE, Troughton MB, Lopez CE, Kruse JH, Banayan JM. Effect of metoclopramide on gastric volume and nausea and vomiting in fasted patients undergoing elective cesarean delivery: a randomized clinical equivalence trial. Int J Obstet Anesth. 2025 Nov;64:104754. doi: 10.1016/j.ijoa.2025.104754. Epub 2025 Aug 14.

    PubMed 40882347

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Study drug metoclopramide in people with Pregnancy and Cesarean Section, run by Northwestern University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 May 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Gastric Volume (mL) (time frame: 30 minutes after administration of study drug). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05033041, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Sep 2025.

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