Dr. Mrinalini Balki, MD
Claim this profileMount Sinai Hospital
Studies Postpartum Hemorrhage
Studies Bleeding
13 reported clinical trials
11 drugs studied
Affiliated Hospitals
Clinical Trials Mrinalini Balki, MD is currently running
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.
Recruiting1 award N/A1 criteria
Epidural Catheter
for Labor Pain
Epidural analgesia was introduced to the world of obstetrics in 1909 by Walter Stoeckel. Over the following 100 years it has developed to become the gold-standard for delivery of intra-partum analgesia, with between 60 and 75% of North American parturients receiving an epidural during their labor. Effective labor analgesia has been shown to improve maternal and fetal outcomes. One aspect of catheter insertion that has not been fully evaluated, and with very little recent work undertaken, is the optimal length of epidural catheter to be left in the epidural space. Dislodgement or displacement of epidural catheter remains a significant cause for failure with analgesia. Novel methods of fixation may further reduce the risk of catheter migration. Another factor is the direction of travel within the epidural space, only 13% of lumbar catheters remain uncoiled after insertion of more than 4 cm into the epidural space. Hypothesis: The investigators hypothesize that catheters inserted to 4 cm will have a lower rate of failure when compared to those inserted to 5 cm. Objective: This study aims to evaluate the difference in quality of labor analgesia delivered by epidural catheters inserted to either 4 or 5 cm into the epidural space. This study will be conducted as an interventional double-blinded randomised control trial to establish best practice.
Recruiting1 award N/A4 criteria
More about Mrinalini Balki, MD
Clinical Trial Related1 year of experience running clinical trials · Led 13 trials as a Principal Investigator · 7 Active Clinical TrialsTreatments Mrinalini Balki, MD has experience with
- Oxytocin
- Carbetocin
- Combined Spinal-epidural Analgesia
- Norepinephrine
- Ephedrine
- Phenylephrine
Breakdown of trials Mrinalini Balki, MD has run
Postpartum Hemorrhage
Bleeding
Labor Pain
Obesity
Low Blood Pressure
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Frequently asked questions
Do I need insurance to participate in a trial?
Almost all clinical trials will cover the cost of the ‘trial drug’ — so no insurance is required for this. For trials where this trial drug is given alongside an already-approved medication, there may be a cost (which your insurance would normally cover).
What does Mrinalini Balki, MD specialize in?
Mrinalini Balki, MD focuses on Postpartum Hemorrhage and Bleeding. In particular, much of their work with Postpartum Hemorrhage has involved treating patients, or patients who are undergoing treatment.
Is Mrinalini Balki, MD currently recruiting for clinical trials?
Yes, Mrinalini Balki, MD is currently recruiting for 7 clinical trials in Toronto Ontario. If you're interested in participating, you should apply.
Are there any treatments that Mrinalini Balki, MD has studied deeply?
Yes, Mrinalini Balki, MD has studied treatments such as Oxytocin, Carbetocin, Combined Spinal-epidural Analgesia.
What is the best way to schedule an appointment with Mrinalini Balki, MD?
Apply for one of the trials that Mrinalini Balki, MD is conducting.
What is the office address of Mrinalini Balki, MD?
The office of Mrinalini Balki, MD is located at: Mount Sinai Hospital, Toronto, Ontario M5G1X5 Canada. This is the address for their practice at the Mount Sinai Hospital.
Is there any support for travel costs?
The coverage of travel expenses can vary greatly between different clinical trials. Please see more financial detail in the trials you’re interested to apply.