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NCT Number: NCT07793760

Dexamethasone Versus Ondansetron for Preventing Post-Spinal Hypotension in Preeclampsia

This study compares the efficacy and safety of intravenous dexamethasone versus intravenous ondansetron in preventing low blood pressure (hypotension) following spinal anesthesia in pregnant women with preeclampsia undergoing scheduled cesarean delivery.

Spinal anesthesia is the preferred anesthetic method for cesarean delivery, but it frequently causes a sudden drop in maternal blood pressure. In patients with preeclampsia, post-spinal hypotension can compromise blood flow to the placenta and vital organs. While traditional vasopressor medications are used to restore blood pressure, non-adrenergic prophylactic agents such as dexamethasone and ondansetron may help maintain hemodynamic stability through different physiological pathways.

Participants will be randomly assigned to receive either intravenous dexamethasone (8 mg) or intravenous ondansetron (4 mg) 15 minutes prior to the initiation of spinal anesthesia. Blood pressure, heart rate, vasopressor requirements, optic nerve sheath diameter, and maternal and neonatal outcomes will be monitored throughout the surgery and during the immediate postoperative period.

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Key information

Conditions

Preeclampsia Cesarean Section Female Urogenital Diseases and Pregnancy Complications Hypertension, Pregnancy-Induced Pre-Eclampsia Pregnancy Complications Spinal Anesthesia-Induced Hypotension Urogenital Diseases

Age range

18 year–40 year

Sex eligibility

Female

Study type

Interventional

Phase

Phase 4

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Pregnant women aged 18 to 40 years.
  • American Society of Anesthesiologists (ASA) physical status III.
  • Diagnosed with preeclampsia (new onset of hypertension ≥140/90 mmHg with proteinuria occurring after 20 weeks of gestation according to ACOG and ISSHP guidelines).
  • Scheduled for elective cesarean delivery under spinal anesthesia.

Exclusion criteria

  • Peripartum bleeding.
  • Obesity (body mass index ≥40 kg/m²).
  • Coagulation disorders (platelet count < 75,000/μL).
  • Neurological disorders.
  • Previous or current systemic corticosteroid therapy.
  • Known cardiac disease.
  • History of diabetes mellitus.
  • Renal dysfunction (serum creatinine > 2 mg/dL).
  • Hepatic dysfunction (serum liver enzymes > 2 times the upper limit of normal).
  • Known hypersensitivity to dexamethasone, ondansetron, or any component of the study medications.
  • Emergency cesarean delivery.
  • Known fetal congenital anomalies.

Treatment and study plan

Dexamethasone

Drug

Intravenous dexamethasone 8 mg diluted with 0.9% normal saline to a total volume of 10 mL, administered slowly over approximately one minute, 15 minutes before the induction of spinal anesthesia.

ondansetron

Drug

Intravenous ondansetron 4 mg diluted with 0.9% normal saline to a total volume of 10 mL, administered slowly over approximately one minute, 15 minutes before the induction of spinal anesthesia.

Primary outcomes

  1. Incidence of post-spinal hypotension

    Time frame: 1 hour

    Number of participants with a decrease in systolic blood pressure below 80% of baseline.

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Intravenous Dexamethasone Versus Ondansetron in the Prevention of Post-Spinal Hypotension in Preeclampsia Patients Undergoing Caesarean Delivery: A Prospective Randomized Clinical Trial

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Aug 31, 2026
Registry last updated
Aug 31, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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