Efficacy of Maternal Body Temperature Preservation during Caesarean Section: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENTing-ting , YUXiao-dong ,  DAIXiao-wen

Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;

Corresponding?author：

DAIXiao-wen, Email: 279196231@qq.com

Keywords：

Body temperature preservation; Cesarean section; Shivering; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160106

Video：

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Objective To systematically review the efficacy of maternal body temperature preservation during caesarean section. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 2, 2015), WanFang Data, CBM and CNKI were searched from inception to July 2015 to collect randomized controlled trials (RCTs) of body temperature preservation in patients with caesarean delivery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan5.3 software. Results A total of 15 RCTs involving 1 331 patients were included. The results of meta-analysis showed that patients in the temperature preservation group had a smaller body temperature variation (MD= –0.22, 95%CI –0.32 to –0.13, P < 0.000?01) and a lower incidence of shivering (RR=0.53, 95%CI 0.42 to 0.67, P < 0.000?01) than patients in the control group. There were no statistical differences between the two groups in blood loss (MD= –13.77, 95%CI –33.95 to 6.42, P=0.18) and newborn Apgar score (MD=0.12, 95%CI –0.37 to 0.6, P=0.64). Conclusions Current evidence shows that body temperature preservation measures can better protect patients with caesarean delivery. Specifically, body temperature preservation measures could reduce patients’ body temperature variation and incidence of shivering but had no effect on blood loss and newborn Apgar score. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： CHENTing-ting, YUXiao-dong, DAIXiao-wen. Efficacy of Maternal Body Temperature Preservation during Caesarean Section: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2016, 16(6): 682-688. doi: 10.7507/1672-2531.20160106 Copy

1.	?Sessler DI. Perioperative heat balance. Anesthesiology, 2000, 92(2): 578-596.
2.	Crowley LJ, Buggy DJ. Shivering and neuraxial anesthesia. Reg Anesth Pain Med, 2008, 33(3): 241-252.
3.	Ganji Z, Shirvani MA, Rezaei-Abhari F, et al. The effect of intermittent local heat and cold on labor pain and child birth outcome. Iran J Nurs Midwifery Res, 2013, 18(4): 298-303.
4.	Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: www.cochrane-handbook.org.
5.	Butwick AJ, Lipman SS, Carvalho B. Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. Anesth Analg, 2007, 105(5): 1413-1419.
6.	Chakladar A, Dixon MJ, Crook D, et al. The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial. Int J Obstet Anesth, 2014, 23(4): 309-316.
7.	Chan VW, Morley-Forster PK, Vosu HA. Temperature changes and shivering after epidural anesthesia for cesarean section. Reg Anesth, 1989, 14(1): 48-52.
8.	Chung SH, Lee BS, Yang HJ, et al. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean J Anesthesiol, 2012, 62(5): 454-460.
9.	Fallis WM, Hamelin K, Symonds J, et al. Maternal and newborn outcomes related to maternal warming during cesarean delivery. J Obstet Gynecol Neonatal Nurs, 2006, 35(3): 324-331.
10.	Goyal P, Kundra S, Sharma S, et al. Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia. J Obstet Anaesth Crit Care, 2011, 1(2): 73-77.
11.	Horn EP, Schroeder F, Gottschalk A, et al. Active warming during cesarean delivery. Anesth Analg, 2002, 94(2): 409-414.
12.	Horn EP, Bein B, Steinfath M, et al. The incidence and prevention of hypothermia in newborn bonding after cesarean delivery: a randomized controlled trial. Anesth Analg, 2014, 118(5): 997-1002.
13.	J?rgensen HS, Bach LF, Helbo-Hansen HS, et al. Warm or cold saline for volume preload before spinal anaesthesia for caesarean section? Int J Obstet Anesth, 2000, 9(1): 20-25.
14.	Paris LG, Seitz M, McElroy KG, et al. A randomized controlled trial to improve outcomes utilizing various warming techniques during cesarean birth. J Obstet Gynecol Neonatal Nurs, 2014, 43(6): 719-728.
15.	Woolnough M, Allam J, Hemingway C, et al. Intra-operative fluid warming in elective caesarean section: a blinded randomised controlled trial. Int J Obstet Anesth, 2009, 18(4): 346-351.
16.	Yokoyama K, Suzuki M, Shimada Y, et al. Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for cesarean delivery. J Clin Anesth, 2009, 21(4): 242-248.
17.	白莉平, 張瑛, 宋愛玲, 等. 術中保溫聯合能量合劑對剖宮產患者術中寒戰防治研究. 陜西醫學雜志, 2015, 44(7): 895-896.
18.	陳少娟, 郭雅梅, 賴梅, 等. 術中應用保溫措施防止剖宮產產婦寒顫. 國際醫藥衛生導報, 2010, 16(19): 2407-2409.
19.	冷蔚蔚, 周素玲, 張維峰, 等. 水循環保溫毯用于聯合麻醉下剖宮產手術的效果觀察. 護理學報, 2014, 21(12): 42-44.
20.	Van Poucke S, Stevens K, Kicken C, et al. Platelet function during hypothermia in experimental mock circulation. Artif Organs, 2015, 4(3): 288-293.
21.	Miller SS, Lee HC, Gould JB. Hypothermia in very low birth weight infants: distribution, risk factors and outcomes. J Perinatol, 2011, 31: S49-S56.
22.	Schmied H, Kurz A, Sessler DI, et al. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet, 1996, 347(8997): 289-292.

1. ?Sessler DI. Perioperative heat balance. Anesthesiology, 2000, 92(2): 578-596.
2. Crowley LJ, Buggy DJ. Shivering and neuraxial anesthesia. Reg Anesth Pain Med, 2008, 33(3): 241-252.
3. Ganji Z, Shirvani MA, Rezaei-Abhari F, et al. The effect of intermittent local heat and cold on labor pain and child birth outcome. Iran J Nurs Midwifery Res, 2013, 18(4): 298-303.
4. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: www.cochrane-handbook.org.
5. Butwick AJ, Lipman SS, Carvalho B. Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. Anesth Analg, 2007, 105(5): 1413-1419.
6. Chakladar A, Dixon MJ, Crook D, et al. The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial. Int J Obstet Anesth, 2014, 23(4): 309-316.
7. Chan VW, Morley-Forster PK, Vosu HA. Temperature changes and shivering after epidural anesthesia for cesarean section. Reg Anesth, 1989, 14(1): 48-52.
8. Chung SH, Lee BS, Yang HJ, et al. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean J Anesthesiol, 2012, 62(5): 454-460.
9. Fallis WM, Hamelin K, Symonds J, et al. Maternal and newborn outcomes related to maternal warming during cesarean delivery. J Obstet Gynecol Neonatal Nurs, 2006, 35(3): 324-331.
10. Goyal P, Kundra S, Sharma S, et al. Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia. J Obstet Anaesth Crit Care, 2011, 1(2): 73-77.
11. Horn EP, Schroeder F, Gottschalk A, et al. Active warming during cesarean delivery. Anesth Analg, 2002, 94(2): 409-414.
12. Horn EP, Bein B, Steinfath M, et al. The incidence and prevention of hypothermia in newborn bonding after cesarean delivery: a randomized controlled trial. Anesth Analg, 2014, 118(5): 997-1002.
13. J?rgensen HS, Bach LF, Helbo-Hansen HS, et al. Warm or cold saline for volume preload before spinal anaesthesia for caesarean section? Int J Obstet Anesth, 2000, 9(1): 20-25.
14. Paris LG, Seitz M, McElroy KG, et al. A randomized controlled trial to improve outcomes utilizing various warming techniques during cesarean birth. J Obstet Gynecol Neonatal Nurs, 2014, 43(6): 719-728.
15. Woolnough M, Allam J, Hemingway C, et al. Intra-operative fluid warming in elective caesarean section: a blinded randomised controlled trial. Int J Obstet Anesth, 2009, 18(4): 346-351.
16. Yokoyama K, Suzuki M, Shimada Y, et al. Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for cesarean delivery. J Clin Anesth, 2009, 21(4): 242-248.
17. 白莉平, 張瑛, 宋愛玲, 等. 術中保溫聯合能量合劑對剖宮產患者術中寒戰防治研究. 陜西醫學雜志, 2015, 44(7): 895-896.
18. 陳少娟, 郭雅梅, 賴梅, 等. 術中應用保溫措施防止剖宮產產婦寒顫. 國際醫藥衛生導報, 2010, 16(19): 2407-2409.
19. 冷蔚蔚, 周素玲, 張維峰, 等. 水循環保溫毯用于聯合麻醉下剖宮產手術的效果觀察. 護理學報, 2014, 21(12): 42-44.
20. Van Poucke S, Stevens K, Kicken C, et al. Platelet function during hypothermia in experimental mock circulation. Artif Organs, 2015, 4(3): 288-293.
21. Miller SS, Lee HC, Gould JB. Hypothermia in very low birth weight infants: distribution, risk factors and outcomes. J Perinatol, 2011, 31: S49-S56.
22. Schmied H, Kurz A, Sessler DI, et al. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet, 1996, 347(8997): 289-292.

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Efficacy of Maternal Body Temperature Preservation during Caesarean Section: A Systematic Review

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