Objective: We conducted a systematic review and meta-analysis to evaluate the fetomaternal outcomes after the administration of norepinephrine or phenylephrine for the treatment of post spinal hypotension in preeclamptic women undergoing a cesarean section.
Data Sources: We searched on PubMed, Embase, Scopus, Cochrane CENTRAL, and clinicaltrials.gov from inception till June 2024.
Study Selection: Randomized controlled trials of preeclamptic women receiving norepinephrine or phenylephrine for post spinal hypotension were included.
Data Extraction And Synthesis: Two reviewers extracted data onto an Excel spreadsheet. R version 4.4 was used for statistical analysis. Risk ratios (RR) and their 95% confidence intervals (CIs) were calculated and pooled using the random effects model. Cochrane's risk of bias (RoB 2) tool was used for quality assessment. This review has been registered with PROSPERO (CRD42024532740).
Results: A total of 4 trials, comprising 413 participants, were included in this review. 206 patients received norepinephrine, while 207 received phenylephrine. The incidence of maternal bradycardia was significantly lower in the norepinephrine group compared with the phenylephrine group (RR = 0.25, 95 % CI = 0.16 to 0.39, p < 0.01). There were no statistical differences in other maternal outcomes or in the umbilical artery and umbilical vein blood gas analysis values. We also analyzed adverse events such as nausea (RR = 1.00, 95 % CI: 0.62 to 1.60, p = 1.00) and vomiting (RR = 0.99, 95 % CI: 0.89 to 1.11, p = 0.61), but they did not show a significant association with any group. All the trials had a moderate or low risk of bias.
Conclusion: Bolus doses of NE and PE for the treatment of post-spinal hypotension in preeclamptic women undergoing cesarean sections were found to exhibit comparable neonatal outcomes. However, NE provided superior maternal safety due to a lower incidence of bradycardia compared to PE.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ejogrb.2024.10.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Role of prophylactic intravenous calcium in prevention of postspinal hypotension among women with preeclampsia undergoing cesarean delivery: a placebo controlled randomized clinical trial.
Am J Obstet Gynecol MFM
November 2024
Department of Anesthesiology and Critical Care, Jawaharlal Institute of Post Graduate Medical Education and Research (Yadav, Lata, Chakravarthy, and Jha), Puducherry, India. Electronic address:
Background: Preeclamptic women, in addition to traditional antihypertensive medications, often receive magnesium supplementation and are at increased risk of postspinal hypotension Postspinal hypotension increases the risk of fetomaternal morbidity. Calcium is a physiological antagonist of magnesium in vascular smooth muscle. Therefore, the study hypothesized that calcium is better suited for preserving systemic vascular resistance and preventing postspinal hypotension during cesarean delivery.
View Article and Find Full Text PDFEfficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis.
Eur J Obstet Gynecol Reprod Biol
December 2024
Nursing & Midwifery Research Department (NMRD), Hamad Medical Corporation, Doha, Qatar; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar. Electronic address:
Objective: We conducted a systematic review and meta-analysis to evaluate the fetomaternal outcomes after the administration of norepinephrine or phenylephrine for the treatment of post spinal hypotension in preeclamptic women undergoing a cesarean section.
Data Sources: We searched on PubMed, Embase, Scopus, Cochrane CENTRAL, and clinicaltrials.gov from inception till June 2024.
Determining the relationship between severity of proteinuria and adverse maternal and neonatal outcomes in patients with preeclampsia.
Pregnancy Hypertens
December 2024
Department of Obstetrics and Gynaecology, University of Pretoria Faculty of Health Sciences, Kalafong Provincial Tertiary Hospital, 10 Kalafong Road, Atteridgeville, Gauteng 0008, South Africa.
Objectives: To investigate the relationship between the severity of proteinuria and adverse maternal and neonatal outcomes in patients with preeclampsia (PE).
Design: Prospective cohort study conducted in Gauteng, South Africaover 12 months. Patientswith PE 18 years or olderwith singleton pregnancieswere recruited.
Impact of hyponatremia in preeclamptic patients with severe features.
PLoS One
July 2024
Pediatrics, Division of Pediatric Critical Care Medicine, Penn State Health Children's Hospital, Hershey, Pennsylvania, United States of America.
Hyponatremia, though common in women with preeclampsia, has not been well studied. Our primary objectives are to assess the clinical characteristics and emergency therapy applied to subjects diagnosed with preeclampsia. We hypothesize that hyponatremia present in preeclamptic patients with severe features is associated with greater use of emergency hypertensives, antenatal steroids, and cesarean delivery.
View Article and Find Full Text PDFDose-Response Study of Norepinephrine Infusion for Maternal Hypotension in Preeclamptic Patients Undergoing Cesarean Delivery Under Spinal Anesthesia.
Clin Pharmacokinet
June 2024
Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, 804S Shengli Street, Yinchuan, Ningxia 750004, China.
Background And Objective: Spinal anesthesia remains the preferred mode of anesthesia for preeclamptic patients during cesarean delivery. We investigated the incidence of maternal hypotension under spinal anesthesia during cesarean delivery, by comparing different prophylactic infusion rates of norepinephrine with normal saline.
Methods: We randomly allocated 180 preeclamptic patients (45 in each groups) aged 18-45 scheduled for cesarean delivery to receive one of four prophylactic norepinephrine infusions at doses of 0 (normal saline group), 0.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!