A randomized controlled trial to improve outcomes utilizing various warming techniques during cesarean birth

Abstract

Objective: To examine the effect of various warming methods during cesarean birth (CB) on maternal core body temperature, maternal hypothermia, and other maternal and neonatal outcomes.

Design: Three-arm randomized controlled trial.

Setting: Perinatal unit in a large community hospital in the mid-Atlantic United States.

Participants: Two hundred twenty-six (226) pregnant women undergoing planned CB.

Methods: Women were randomly assigned to one of three groups (usual care, warmed fluids, or warmed underbody pad). Warming treatments began preoperatively and continued for 2 hours postoperatively. Study nurses measured outcomes at defined intervals.

Results: Both warming techniques affected maternal temperatures and the incidence of hypothermia. The warmed fluids group had significantly higher temperatures in the operating room, whereas the warmed underbody pad group had significantly higher temperatures in the recovery room. Although none of the other outcomes was statistically different among groups, the findings have implications for practice. Apgar scores were proportionately lower in the usual care group, and maternal request for additional warming was proportionately higher in the usual care group.

Conclusion: This study adds information on ways to maintain maternal normothermia during surgery. By understanding maternal hypothermia during CB, nurses can use best practice to obtain optimal maternal and neonatal outcomes.

Keywords: cesarean birth; hypothermia; prevention.