Mrinalini Balki | Department of Physiology

Dr. Mrinalini Balki, MD

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Mount Sinai Hospital

Studies Postpartum Hemorrhage
Studies Labor Pain
13 reported clinical trials
11 drugs studied

Area of expertise

1

Postpartum Hemorrhage

Mrinalini Balki, MD has run 8 trials for Postpartum Hemorrhage.

2

Labor Pain

Mrinalini Balki, MD has run 3 trials for Labor Pain. Some of their research focus areas include:

Stage I
Stage II

Affiliated Hospitals

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Mount Sinai Hospital

Clinical Trials Mrinalini Balki, MD is currently running

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Spinal-Epidural Analgesia

for Labor Pain

Combined spinal-epidural (CSE) for labor analgesia has been used for many years and is practiced commonly at our institution, especially when the patient requests immediate pain relief. CSE is not only beneficial for its faster onset of analgesia, but also it is favorable in relation to the need for rescue analgesia, urinary retention, and rate of instrumental delivery compared to the traditional epidural. Despite its beneficial effects, there is a risk of about 15-30% of developing abnormal fetal heart rate following CSE. This is self-resolving with minimal or no intervention. Although the cause of fetal bradycardia is not fully elucidated, variations in uterine artery blood flow after epidural analgesia are thought to be due to the interaction of numerous events related to blockade of sympathetic innervations, fluid administration, maternal hypotension, uterine vascular effects of sympathetic block, fluctuations in circulating catecholamines, and possibly the effect of opioids. Similar mechanism is thought to be a cause of fetal bradycardia after the CSE with its faster onset and superior block. Maternal or fetal circulation during labor can be assessed using continuous-wave Doppler ultrasound to monitor maternal uterine artery (UtA) and fetal umbilical artery (UmA) velocity waveforms to detect changes in blood flow. The velocimetry indices mentioned above have been often used to assess the changes in the blood flow before and after the induction of epidural analgesia during labor in several studies. Although there are some studies regarding the effect of labor epidural analgesia using velocimetry indices, but there is currently no published study evaluating velocimetry indices of uterine and umbilical arteries before and after the induction of CSE. Thus, the aim of this study is to investigate the impact of CSE to maternal and fetal blood flow to evaluate the relationships. The investigators hypothesize that both uterine artery and umbilical artery blood flow are reduced after the induction of CSE, which may be responsible for the occurrence of fetal bradycardia.

Recruiting

1 award

N/A

1 criteria

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Ephedrine, Phenylephrine, and Norepinephrine

for Gestational Diabetes

The goal of this study is to learn about how medication that is used to help treat low blood pressure during a Cesarean delivery (CD) can cause changes to the uterine muscle tissue and its ability to contract, in patients with Type II and gestational diabetes. Spinal anesthesia administered during elective CD has been known to cause hypotension (low blood pressure) as a side effect during the procedure, and is prevented by administration of vasopressors (medication to raise blood pressure) by the anesthesiologist after the delivery of the baby. Vasopressors treat hypotension by interacting with receptors on blood vessels that increase blood pressure, which can also cause changes to uterine contractility. Inadequate uterine contraction after CD can expose mothers to postpartum hemorrhage (PPH), with diabetic patients displaying a 2.5-times higher risk of PPH. It is important to understand how vasopressor(s) might affect the uterine contractility of women with Type II and gestational diabetes. Since medication to contract the uterus is also routinely administered at delivery, it is important to study the effect of these drugs in combination. The purpose of this study is to compare uterine contractility patterns and receptor distribution in women with type II and gestational diabetic and control term pregnant patients with administration of vasopressors. This will be done using small uterine tissue samples taken from the incision site following CD, which will then be used for experiments in the laboratory.

Recruiting

1 award

N/A

More about Mrinalini Balki, MD

Clinical Trial Related

1 year of experience running clinical trials · Led 13 trials as a Principal Investigator · 6 Active Clinical Trials

Treatments Mrinalini Balki, MD has experience with

  • Oxytocin
  • Carbetocin
  • Combined Spinal-epidural Analgesia
  • Norepinephrine
  • Ephedrine
  • Phenylephrine

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